| Doctor Name: | MR. MATTHEW ROBERT FALLON |
| NPI Number: | 1285960914 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 031965-1 |
| Business Practice Address: | 2100 Middle Country Rd Centereach, NY - 117203577 |
| Business Phone Number: | 6315802526 |
| Business Fax Number: | |
| Mailing Address: | 2100 Middle Country Rd, CENTEREACH |
| State: | NY |
| Postal Code: | 117203577 |
| Phone Number: | 6315802526 |
| Fax Number: | |
| NPI Enumeration Date: | 10/30/2009 |
| NPI Last Update Date: | 10/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 283X00000X |
| License Number: | 031965-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Rehabilitation Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A hospital or facility that provides health-related, social and/or vocational services to disabled persons to help them attain their maximum functional capacity. |