Provider Demographics
NPI:1154073468
Name:PERRELLI, FALLON TERESE (DPT)
Entity Type:Individual
Prefix:
First Name:FALLON
Middle Name:TERESE
Last Name:PERRELLI
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 1:201 GRANITE RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2313
Mailing Address - Country:US
Mailing Address - Phone:475-234-4202
Mailing Address - Fax:
Practice Address - Street 1:201 GRANITE RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2313
Practice Address - Country:US
Practice Address - Phone:475-234-4202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010259225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist