Basic Information
Provider Information
NPI: 1558959916
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ATALLAH
FirstName: FRANCIS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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OtherLastName:  
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Mailing Information
Address1: 7 CARNEGIE PLZ
Address2:  
City: CHERRY HILL
State: NJ
PostalCode: 080031000
CountryCode: US
TelephoneNumber: 8774073422
FaxNumber: 8774074329
Practice Location
Address1: 655 MAIN ST S
Address2:  
City: SOUTHBURY
State: CT
PostalCode: 064884220
CountryCode: US
TelephoneNumber: 8774073422
FaxNumber: 8774074329
Other Information
ProviderEnumerationDate: 01/01/2021
LastUpdateDate: 01/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X12560CTY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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