Provider Demographics
NPI:1891291670
Name:FALZONE, ALEXIS JUSTINE
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:JUSTINE
Last Name:FALZONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 TIOGA AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5624
Mailing Address - Country:US
Mailing Address - Phone:570-288-6543
Mailing Address - Fax:
Practice Address - Street 1:425 TIOGA AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5624
Practice Address - Country:US
Practice Address - Phone:570-288-6543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily