Provider Demographics
NPI:1063805067
Name:FALCONER INC
Entity type:Organization
Organization Name:FALCONER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUSUF
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-235-6000
Mailing Address - Street 1:1241 FREEDOM RD
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-4965
Mailing Address - Country:US
Mailing Address - Phone:724-235-6000
Mailing Address - Fax:
Practice Address - Street 1:224 CRAFTON INGRAM SHP CTR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-2353
Practice Address - Country:US
Practice Address - Phone:724-940-9214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-15
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD065152-L261Q00000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty