Healthcare Provider Details

I. General information

NPI: 1558208819
Provider Name (Legal Business Name): ADAMA JOSEPH FALL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 W ROYALTON RD APT 7
BROADVIEW HEIGHTS OH
44147-2450
US

IV. Provider business mailing address

1650 W ROYALTON RD APT 7
BROADVIEW HEIGHTS OH
44147-2450
US

V. Phone/Fax

Practice location:
  • Phone: 347-440-8828
  • Fax:
Mailing address:
  • Phone: 347-440-8828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: