Provider Demographics
NPI:1902966781
Name:EPPLER, BREANNA (PT, DPT, CSCS)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:EPPLER
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 DOBBS FERRY RD
Mailing Address - Street 2:SUITE #209
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1900
Mailing Address - Country:US
Mailing Address - Phone:914-428-9698
Mailing Address - Fax:914-428-6013
Practice Address - Street 1:280 DOBBS FERRY RD
Practice Address - Street 2:SUITE #209
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1900
Practice Address - Country:US
Practice Address - Phone:914-428-9698
Practice Address - Fax:914-428-6013
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028078-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ4W9X1OtherMEDICARE GROUP ID