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General NPI Number Information
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NPI Number | 1063805067
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Entity Type | Organization
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Legal Business Name | FALCONER INC
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Dates
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Enumeration Date | 03/15/2015
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 224 CRAFTON INGRAM SHP CTR
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City | PITTSBURGH
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State | PA
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Zip | 15205-2353
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Country | US
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Telephone | 724-940-9214
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 FREEDOM RD
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City | CRANBERRY TOWNSHIP
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State | PA
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Zip | 16066-4965
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Country | US
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Telephone | 724-235-6000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YUSUF SIDIQUE
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Credential | M.D
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Telephone | 724-235-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MD065152-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | MD065152-L
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License Number State | PA
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