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General NPI Number Information
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NPI Number | 1104908474
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Entity Type | Individual
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Provider Name | CHARLES J. FALSONE O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 2790 EARLYSTOWN RD SUITE A
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City | CENTRE HALL
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State | PA
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Zip | 16828-9149
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Country | US
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Telephone | 814-364-1812
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Fax | 814-364-1813
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Provider Business Mailing Address
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Address Line | 1011 KATHRYN ST
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City | BOALSBURG
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State | PA
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Zip | 16827-1646
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Country | US
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Telephone | 814-466-9093
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG000392
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OEG000392
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License Number State | PA
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