Healthcare Provider Details

I. General information

NPI: 1235053570
Provider Name (Legal Business Name): FALLON MARIE SINISCARCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 S CANAAN RD
CANAAN CT
06018-2502
US

IV. Provider business mailing address

14 ARBOR DR
NEW HARTFORD NY
13413-1202
US

V. Phone/Fax

Practice location:
  • Phone: 315-982-7295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6813
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: