MEDICARE: FALLS EMERGENCY PHYSICIANS, INC.

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	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1295713964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALLS EMERGENCY PHYSICIANS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 670
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-0670
Country	:	US
Telephone Number	:	440-777-6017
Fax Number	:	440-777-6940

Provider Business Practice Location Address
First Line	:	1900 23RD ST
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-1404
Country	:	US
Telephone Number	:	330-971-7436
Fax Number	:	330-971-7344

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSEPH NIENALTOWSKI
Credential	:	D.O.
Telephone Number	:	330-971-7436

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	08/22/2020

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