Provider Demographics
NPI:1164509451
Name:FALVY, ILONA EVA (PT)
Entity Type:Individual
Prefix:MS
First Name:ILONA
Middle Name:EVA
Last Name:FALVY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 FOOTHILL BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CALISTOGA
Mailing Address - State:CA
Mailing Address - Zip Code:94515-1209
Mailing Address - Country:US
Mailing Address - Phone:707-942-8094
Mailing Address - Fax:707-942-8096
Practice Address - Street 1:2436 FOOTHILL BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:CALISTOGA
Practice Address - State:CA
Practice Address - Zip Code:94515-1209
Practice Address - Country:US
Practice Address - Phone:707-942-8094
Practice Address - Fax:707-942-8096
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT194381Medicare ID - Type UnspecifiedMEDICARE ID. NUMBER