Provider Demographics
NPI:1407822901
Name:BREINDEL, ALLEN C (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:C
Last Name:BREINDEL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 MARKET ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-4682
Mailing Address - Country:US
Mailing Address - Phone:814-726-9050
Mailing Address - Fax:814-726-9629
Practice Address - Street 1:2265 MARKET ST
Practice Address - Street 2:SUITE A
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-4682
Practice Address - Country:US
Practice Address - Phone:814-726-9050
Practice Address - Fax:814-726-9629
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT004083L225100000X
PADAPT000360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028775490001Medicaid
PA005552JNGMedicare PIN