1821047333 NPI number — RALPH M FALK MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821047333 NPI number — RALPH M FALK MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

FALK

Provider First Name:

RALPH

Provider Middle Name:

M

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1821047333

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/12/2019

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

200 TECHNOLOGY DR

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

HOOKSETT

Provider Business Mailing Address State Name:

NH

Provider Business Mailing Address Postal Code:

03106-2504

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

603-580-6009

Provider Business Mailing Address Fax Number:

603-580-7952

Provider First Line Business Practice Location Address:

879 LAFAYETTE ROAD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

HAMPTON

Provider Business Practice Location Address State Name:

NH

Provider Business Practice Location Address Postal Code:

03833

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

603-929-1195

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

05/10/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207R00000X , with the licence number:  7971 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 020473740 . This is a "GREAT WEST HEALTHCARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 466264 . This is a "AETNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 010724YPNH01 . This is a "ANTHEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 110123083 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 30008701 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
• Identifier: AA13536 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 020473740 . This is a "TRICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 020473740 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 020473740 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 274960 . This is a "CIGNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 020473740 . This is a "HUMANA CHOICE CARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 020473740 . This is a "HEALTHCARE VALUE MGMT" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".