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NPI Code Detail

MEDICARE: MISS KRISTEN MARY FALLON

MEDICARE:  MISS KRISTEN MARY FALLON
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1912310251
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KRISTEN MARY FALLON
Provider Business Mailing Address
First Line : 21 LONDON TER
Second Line :
City : NEW CITY
State : NY
Zip : 10956-4036
Country : US
Telephone Number : 845-323-0234
Fax Number :
Provider Business Practice Location Address
First Line : 21 LONDON TER
Second Line :
City : NEW CITY
State : NY
Zip : 10956-4036
Country : US
Telephone Number : 845-323-0234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2014
Last Update Date : 06/04/2014

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Directions to “ MISS KRISTEN MARY FALLON ” Practice Location

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