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General NPI Number Information
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NPI Number | 1104345685
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Entity Type | Individual
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Provider Name | NICOLE FALASCO DPT
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Gender | Female
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 09/15/2017
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Provider Practice Location Address
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Address Line | 213 GREENHILL AVE STE C
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City | WILMINGTON
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State | DE
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Zip | 19805-1844
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Country | US
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Telephone | 302-658-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 2611 WOODBERRY RD
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City | BROOMALL
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State | PA
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Zip | 19008-1708
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | JT-0000948
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License Number State | DE
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