Individual
MISS NICOLE ELIZABETH FALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
238 VAN BUREN ST, NEWARK, NJ 07105-2512
(732) 640-3206
Mailing address
622 DRAKE AVE, MIDDLESEX, NJ 08846-2438
(732) 640-3206
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00319200
NJ
Other
Enumeration date
02/27/2022
Last updated
07/14/2023
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