Provider Demographics
NPI:1669851853
Name:CONGENI, BRENNA T (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRENNA
Middle Name:T
Last Name:CONGENI
Suffix:
Gender:F
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 1:1503 RUNAWAY BAY DR
Mailing Address - Street 2:APT 2B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-4814
Mailing Address - Country:US
Mailing Address - Phone:330-322-5542
Mailing Address - Fax:
Practice Address - Street 1:5500 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1476
Practice Address - Country:US
Practice Address - Phone:614-575-9003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.0153122251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics