Provider Demographics
NPI:1871969006
Name:FALENCKI, BRIANNA LYNN (DPT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LYNN
Last Name:FALENCKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 W EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2234
Mailing Address - Country:US
Mailing Address - Phone:610-789-9887
Mailing Address - Fax:610-789-9883
Practice Address - Street 1:57 W EAGLE RD
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2234
Practice Address - Country:US
Practice Address - Phone:610-789-9887
Practice Address - Fax:610-789-9883
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024676208100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT024676OtherPROVIDER TAXONOMY - 225100000X