Most Relevant Information
Provider Data
| NPI Number: | 1003647884 |
| Provider Name: | FALLON KATHLEEN MARTENSEN |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/12/2024 |
| Last Updated: | 08/12/2024 |
Provider Practice Location
35 THE MOOR
EAST ISLIP
NY
117302922
Practice Location Phone/Fax
| Phone: | 6317040930 |
| Fax: |
Provider Mailing Location
35 THE MOOR
EAST ISLIP
NY
117302922
Provider Mailing Phone/Fax
| Phone: | 6317040930 |
| Fax: |