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General NPI Number Information
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NPI Number | 1679912257
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Entity Type | Organization
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Legal Business Name | FRANK FAILLA PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 10/02/2014
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Provider Practice Location Address
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Address Line | 623 LAFAYETTE AVE
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City | HAWTHORNE
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State | NJ
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Zip | 07506-2439
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Country | US
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Telephone | 917-684-9789
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Fax | 877-642-1441
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Provider Business Mailing Address
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Address Line | 15 THE CRESCENT UNIT 5
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2664
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Country | US
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Telephone | 917-684-9789
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Fax | 877-642-1441
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Authorized Official
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Title or Position | OWNER/DPT
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Name | MR. FRANK FAILLA
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Credential | DPT
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Telephone | 917-684-9789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01254100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | NJ
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