Basic Information
| Provider Information | |||||||||
| NPI: | 1639395064 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MERCER-FALKOFF | ||||||||
| FirstName: | ALEAGIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 950 CAMPBELL AVE | ||||||||
| Address2: | VACT DEPT OF MEDICINE- 111 | ||||||||
| City: | WEST HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065162770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2039325711 | ||||||||
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| Practice Location | |||||||||
| Address1: | 950 CAMPBELL AVE | ||||||||
| Address2: | VACT DEPT OF MEDICINE- 111 | ||||||||
| City: | WEST HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065162770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2039325711 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 01/21/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | LP00836 | RI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | D74014 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.