Provider Demographics
NPI:1215002514
Name:FALK, DENISE M (DO)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:FALK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:SPARTANSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16434
Mailing Address - Country:US
Mailing Address - Phone:814-654-7334
Mailing Address - Fax:814-654-7553
Practice Address - Street 1:35255 BROWN HILL RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:PA
Practice Address - Zip Code:16438
Practice Address - Country:US
Practice Address - Phone:814-694-2339
Practice Address - Fax:814-694-2176
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05012215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H66052Medicare UPIN
PA059636QSEMedicare PIN