Provider Demographics
NPI:1629379763
Name:FALCONI, TERESITA L (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:L
Last Name:FALCONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5791 ROCK HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-1913
Mailing Address - Country:US
Mailing Address - Phone:216-398-0819
Mailing Address - Fax:
Practice Address - Street 1:5791 ROCK HAVEN DR
Practice Address - Street 2:
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-1913
Practice Address - Country:US
Practice Address - Phone:216-398-0819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.040368208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice