MEDICARE: TARA FALLON

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	225X00000X	Occupational Therapist	8284	MA

General Provider Information

NPI Number	:	1518305606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA FALLON

Provider Business Mailing Address
First Line	:	6 PROSPECT ST
Second Line	:
City	:	WINCHESTER
State	:	MA
Zip	:	01890-3030
Country	:	US
Telephone Number	:	508-875-9400
Fax Number	:	508-875-9408

Provider Business Practice Location Address
First Line	:	100 WALNUT ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02460-1314
Country	:	US
Telephone Number	:	617-559-9360
Fax Number	:

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

Provider Enumeration Date	:	06/11/2013
Last Update Date	:	03/05/2026

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Directions to “ TARA FALLON ” Practice Location

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