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General NPI Number Information
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NPI Number | 1730406448
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Entity Type | Individual
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Provider Name | MS. MARGARET G FALLON
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Gender | Female
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Dates
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Enumeration Date | 04/21/2010
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 200 GOVERNORS AVE
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City | MEDFORD
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State | MA
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Zip | 02155-1644
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Country | US
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Telephone | 781-306-6888
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Fax | 781-306-6285
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Provider Business Mailing Address
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Address Line | 200 GOVERNORS AVE
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City | MEDFORD
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State | MA
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Zip | 02155-1644
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Country | US
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Telephone | 781-306-6888
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Fax | 781-306-6285
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN272651
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN272651
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License Number State | MA
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