Provider Demographics
NPI:1457741209
Name:FALIN, MARISSA
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:FALIN
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 1:4848 COMMERCIAL DR
Mailing Address - Street 2:SUITE 700
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-6237
Mailing Address - Country:US
Mailing Address - Phone:315-732-7528
Mailing Address - Fax:315-732-7553
Practice Address - Street 1:4848 COMMERCIAL DR
Practice Address - Street 2:SUITE 700
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-6237
Practice Address - Country:US
Practice Address - Phone:315-732-7528
Practice Address - Fax:315-732-7553
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000027041237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY14000027041OtherLICENSE NUMBER