Provider Demographics
NPI:1639406689
Name:FALLICK, HARRY ARTHUR (DO)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:ARTHUR
Last Name:FALLICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2555 INDUSTRY LN
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3933
Mailing Address - Country:US
Mailing Address - Phone:610-630-6800
Mailing Address - Fax:610-630-6202
Practice Address - Street 1:2555 INDUSTRY LN
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-3933
Practice Address - Country:US
Practice Address - Phone:610-630-6800
Practice Address - Fax:610-630-6202
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005218L208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery