Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 003594 | NY |
NPI | 1871703231 |
---|---|
Provider Name | Dr. Joan M Fallon |
First Address | Yonkers, NY 10704-1068 |
Second Address | Yonkers, NY 10704-1068 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T52497 | (02) |