Provider Demographics
NPI:1568929644
Name:FYZICAL PAOLI LLC
Entity Type:Organization
Organization Name:FYZICAL PAOLI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TALAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-558-3353
Mailing Address - Street 1:40 DARBY RD STE 1
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1481
Mailing Address - Country:US
Mailing Address - Phone:917-558-3353
Mailing Address - Fax:
Practice Address - Street 1:40 DARBY RD STE 1
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1481
Practice Address - Country:US
Practice Address - Phone:917-558-3353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy