Provider Demographics
NPI:1588667331
Name:FALCON, CARLA T (DO)
Entity Type:Individual
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First Name:CARLA
Middle Name:T
Last Name:FALCON
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Gender:F
Credentials:DO
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Mailing Address - Street 1:11279 PERRY HWY
Mailing Address - Street 2:STE 450
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9303
Mailing Address - Country:US
Mailing Address - Phone:724-933-1100
Mailing Address - Fax:724-933-1160
Practice Address - Street 1:4075 MONROEVILLE BLVD
Practice Address - Street 2:STE 125
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2526
Practice Address - Country:US
Practice Address - Phone:412-373-1717
Practice Address - Fax:412-856-8460
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAOS006529L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011998540003Medicaid
PA0011998540003Medicaid