Provider Demographics
NPI:1063992923
Name:BALAKRISHNAN, SWAPNA (PT,DPT)
Entity type:Individual
Prefix:DR
First Name:SWAPNA
Middle Name:
Last Name:BALAKRISHNAN
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 1:724 GREAT RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1243
Mailing Address - Country:US
Mailing Address - Phone:631-681-6049
Mailing Address - Fax:
Practice Address - Street 1:150 WATER ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6213
Practice Address - Country:US
Practice Address - Phone:978-374-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21672225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist