Provider Demographics
NPI:1457627721
Name:FALKOWSKI, EVELYN M (MEDMACCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:M
Last Name:FALKOWSKI
Suffix:
Gender:F
Credentials:MEDMACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 PENNEWILL DR
Mailing Address - Street 2:LEEDOM ESTATES
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-1811
Mailing Address - Country:US
Mailing Address - Phone:302-328-3125
Mailing Address - Fax:
Practice Address - Street 1:193 N BROADWAY
Practice Address - Street 2:
Practice Address - City:PENNSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08070-1417
Practice Address - Country:US
Practice Address - Phone:856-678-9400
Practice Address - Fax:856-678-9401
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00395000235Z00000X
DE01-0001007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist