Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 22DI02538600 | NJ |
NPI | 1144612250 |
---|---|
Provider Name | Dr. Carla Yvonne Falcon |
First Address | Basking Ridge, NJ 07920-2402 |
Second Address | Newark, NJ 07103-2495 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2015 |
Last Update Date | 20/04/2016 |