Provider Demographics
NPI:1235573288
Name:ALLEN, BRIDGETT CYNTHIA FALLON (DPT)
Entity Type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:CYNTHIA FALLON
Last Name:ALLEN
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 1:88 W SHORE DR
Mailing Address - Street 2:
Mailing Address - City:VALATIE
Mailing Address - State:NY
Mailing Address - Zip Code:12184-3231
Mailing Address - Country:US
Mailing Address - Phone:631-678-6257
Mailing Address - Fax:
Practice Address - Street 1:480 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:MA
Practice Address - Zip Code:01238-9265
Practice Address - Country:US
Practice Address - Phone:413-243-3477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2015-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400105072Medicare UPIN