Provider Demographics
NPI:1265573208
Name:FALCON, ANA NOEMI (MA)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:NOEMI
Last Name:FALCON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HILLSIDE AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3030
Mailing Address - Country:US
Mailing Address - Phone:908-456-2699
Mailing Address - Fax:732-326-9708
Practice Address - Street 1:110 HILLSIDE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3030
Practice Address - Country:US
Practice Address - Phone:908-456-2699
Practice Address - Fax:732-326-9708
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00216600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health