MEDICARE: ELIANA MARCELA FALCON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	003668-01	NY

General Provider Information

NPI Number	:	1285359992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIANA MARCELA FALCON

Provider Business Mailing Address
First Line	:	3220 92ND ST APT 108
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11369-2401
Country	:	US
Telephone Number	:	347-985-4490
Fax Number	:

Provider Business Practice Location Address
First Line	:	3220 92ND ST APT 108
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11369-2401
Country	:	US
Telephone Number	:	347-985-4490
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2022
Last Update Date	:	08/13/2024

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