Gabrielle Fallon, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

25MT00239600 Issued in NJ

Practice address

1600 Crown Point Rd
West Deptford, NJ 08093-1742

Phone

(856) 848-6110

NPI assigned

Apr 16, 2016

Last updated

Dec 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1770937773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 FRANKFORD AVE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080123727",
            "telephone_number": "856-994-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CROWN POINT RD",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080931742",
            "telephone_number": "856-848-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "GABRIELLE",
        "name_prefix": "Mrs.",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-16",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00239600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Dunn, MS
• Houda Elbaroudi
• Julisa Espinal
• Evan D. O'Brien, M.D., P.C
• Lisa M Ewan, APN
• Alexis Kimberly Farrell
• Heather Ferreira
• Juliarose Fodali, LPC
• Marie Fredrikis
• Kelly A. Froio, P.A.

• Athletic Trainer in West Deptford, NJ
• Providers in West Deptford, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.