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NPI Code Detail

MEDICARE: ANTON FALLAH RPH

MEDICARE: ANTON FALLAH RPH
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
1183500000XPharmacist0411031NY
2183500000XPharmacistRI021121NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821310731
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTON FALLAH RPH
Provider Business Mailing Address
First Line : 8510 3RD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-4610
Country : US
Telephone Number : 718-680-9855
Fax Number : 718-680-9856
Provider Business Practice Location Address
First Line : 8510 3RD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-4610
Country : US
Telephone Number : 718-680-9855
Fax Number : 718-680-9856
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2010
Last Update Date : 02/18/2010

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