Individual
BRIAN FALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
62 WASHINGTON AVE, WESTWOOD, NJ 07675-2000
(201) 664-1118
Mailing address
PO BOX 1014, CLARK, NJ 07066-1014
(732) 855-9751
(735) 855-9755
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01213100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109461DBD
MEDICARE
NJ
Enumeration date
10/20/2006
Last updated
02/26/2020
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