MEDICARE: DAMIGOU N/A FALANI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372600000X	Adult Companion
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1184453284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAMIGOU N/A FALANI

Provider Business Mailing Address
First Line	:	2816 W 30TH ST # A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1862
Country	:	US
Telephone Number	:	718-449-4655
Fax Number	:

Provider Business Practice Location Address
First Line	:	2816 W 30TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1862
Country	:	US
Telephone Number	:	718-449-4655
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	07/29/2024

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