Basic Information
Provider Information
NPI: 1780930032
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RHINEWALD
FirstName: ALEXANDRA
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: DIPONZIO
OtherFirstName: ALEXANDRA
OtherMiddleName: C
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 3399 WINTON RD S
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146233057
CountryCode: US
TelephoneNumber: 5853346000
FaxNumber: 5853342858
Practice Location
Address1: 3399 WINTON RD S
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146233057
CountryCode: US
TelephoneNumber: 5853346000
FaxNumber: 5853342858
Other Information
ProviderEnumerationDate: 07/24/2012
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X035231NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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