Provider Demographics
NPI:1811962418
Name:FALLA, PETER J (LAT)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:J
Last Name:FALLA
Suffix:
Gender:M
Credentials:LAT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11 DEEPWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-3902
Mailing Address - Country:US
Mailing Address - Phone:203-247-1777
Mailing Address - Fax:203-869-4175
Practice Address - Street 1:6 GREENWICH OFFICE PARK
Practice Address - Street 2:ONS PHYSICAL THERAPY
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5151
Practice Address - Country:US
Practice Address - Phone:203-869-2233
Practice Address - Fax:203-869-4175
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0002172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer