Provider Demographics
NPI:1114062973
Name:FALKOFF, PETER HARTLEY (DC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:HARTLEY
Last Name:FALKOFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 THORNDIKE ST
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:MA
Mailing Address - Zip Code:01069-1564
Mailing Address - Country:US
Mailing Address - Phone:413-283-9963
Mailing Address - Fax:413-289-1798
Practice Address - Street 1:1223 THORNDIKE ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-1564
Practice Address - Country:US
Practice Address - Phone:413-283-9963
Practice Address - Fax:413-289-1798
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA806111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
779009OtherTUFTS
MAY35576OtherBCBS
646566OtherHEALTH NEW ENGLAND
3399877OtherUNITED HEALTHCARE
646566OtherACN
646566OtherGREAT WEST
646566OtherHEALTH NEW ENGLAND
646566OtherGREAT WEST