Provider Demographics
NPI:1912642919
Name:FALTAOUS, JOHN ADEL (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ADEL
Last Name:FALTAOUS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 CLIFFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25704-8811
Mailing Address - Country:US
Mailing Address - Phone:304-360-1718
Mailing Address - Fax:
Practice Address - Street 1:150 BERGEN ST # G-142
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2496
Practice Address - Country:US
Practice Address - Phone:973-972-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program