Provider Demographics
NPI:1063506145
Name:SARAJO BUNNY FALK PSY.D PA
Entity Type:Organization
Organization Name:SARAJO BUNNY FALK PSY.D PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:S.BUNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:FALK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-731-0690
Mailing Address - Street 1:PO BOX 934068
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33093-4068
Mailing Address - Country:US
Mailing Address - Phone:954-366-2700
Mailing Address - Fax:954-366-2056
Practice Address - Street 1:3410 ROSE HILL WAY
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-5130
Practice Address - Country:US
Practice Address - Phone:954-731-0690
Practice Address - Fax:954-344-4512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5737103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE0629BMedicare ID - Type Unspecified