Provider Demographics
NPI:1720122732
Name:CHARLES J. FALSONE P.C.
Entity Type:Organization
Organization Name:CHARLES J. FALSONE P.C.
Other - Org Name:IN FOCUS FAMILY VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:FALSONE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:814-364-1812
Mailing Address - Street 1:1011 KATHRYN ST
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-1646
Mailing Address - Country:US
Mailing Address - Phone:814-466-9093
Mailing Address - Fax:
Practice Address - Street 1:2790 EARLYSTOWN RD
Practice Address - Street 2:SUITE A
Practice Address - City:CENTRE HALL
Practice Address - State:PA
Practice Address - Zip Code:16828-9149
Practice Address - Country:US
Practice Address - Phone:814-364-1812
Practice Address - Fax:814-364-1813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG 000392152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADD9538OtherPTAN
PA1104908474OtherGROUP MEMBER NPI
PA034188R8MOtherGROUP MEMBER PROVIDER NUMBER
PAU78620Medicare UPIN
PADD9538OtherPTAN
PA074774Medicare PIN