Provider Demographics
NPI:1619908902
Name:FALK, RODNEY H (MD)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:H
Last Name:FALK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:147 MILK ST
Mailing Address - Street 2:PROVIDER ENROLLMENT - 9TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4806
Mailing Address - Country:US
Mailing Address - Phone:617-421-2508
Mailing Address - Fax:617-421-3487
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-6050
Practice Address - Fax:617-421-6083
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2011-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA44728207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0024945OtherNEIGHBORHOOD HEALTH PLAN
MAE05270OtherBLUE CROSS BLUE SHIELD
MAAA6615OtherHARVARD PILGRIM
MA0108537Medicaid
MD751218OtherTUFTS HEALTH PLAN
MA7767888OtherCIGNA
MA7767888OtherCIGNA
MD751218OtherTUFTS HEALTH PLAN