1811472384 NPI number — NICOLE FALBO NP

Table of content: NICOLE FALBO NP (NPI 1811472384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811472384 NPI number — NICOLE FALBO NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FALBO
Provider First Name:
NICOLE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811472384
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 478
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLARKS SUMMIT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18411-0478
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-586-8186
Provider Business Mailing Address Fax Number:
570-587-8330

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 LAYTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH ABINGTON TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18411-9376
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-587-0758
Provider Business Practice Location Address Fax Number:
570-587-8330
Provider Enumeration Date:
10/01/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  343651 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)