Provider Demographics
NPI:1053647214
Name:FALBY, ELEANOR LITTLEFIELD
Entity Type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:LITTLEFIELD
Last Name:FALBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELLIE
Other - Middle Name:
Other - Last Name:FALBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:17 ADELAIDE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-3414
Mailing Address - Country:US
Mailing Address - Phone:207-730-2292
Mailing Address - Fax:
Practice Address - Street 1:17 ADELAIDE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-3414
Practice Address - Country:US
Practice Address - Phone:207-730-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT1950225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist