Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 290342 | NY |
NPI | 1437315447 |
---|---|
Provider Name | Erica M Fallon |
First Address | New York, NY 10032 |
Second Address | New York, NY 10032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2008 |
Last Update Date | 23/07/2020 |