Provider Demographics
NPI:1376184655
Name:POLLIFRONE, FALON ROSE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:FALON
Middle Name:ROSE
Last Name:POLLIFRONE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:17177 N LAUREL PARK DR STE 131
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3952
Mailing Address - Country:US
Mailing Address - Phone:734-462-3210
Mailing Address - Fax:
Practice Address - Street 1:17177 N LAUREL PARK DR STE 131
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3952
Practice Address - Country:US
Practice Address - Phone:734-462-3210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601009685363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant