MEDICARE: DR. JOAN M FALLON DC

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	111NN0400X	Neurology Chiropractor	003594	NY

General Provider Information

NPI Number	:	1871703231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOAN M FALLON DC

Provider Business Mailing Address
First Line	:	1234 CENTRAL PARK AVE
Second Line	:	SUITE 1B
City	:	YONKERS
State	:	NY
Zip	:	10704-1068
Country	:	US
Telephone Number	:	914-779-9300
Fax Number	:	914-779-1148

Provider Business Practice Location Address
First Line	:	1234 CENTRAL PARK AVE
Second Line	:	SUITE 1B
City	:	YONKERS
State	:	NY
Zip	:	10704-1068
Country	:	US
Telephone Number	:	914-779-9300
Fax Number	:	914-779-1148

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/08/2007

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