Provider Demographics
NPI:1689601643
Name:FALDMAN, CLIFFORD LEWIS (DC)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:LEWIS
Last Name:FALDMAN
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 1:62 PORTLAND ROAD
Mailing Address - Street 2:SUITE 47
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043
Mailing Address - Country:US
Mailing Address - Phone:207-985-3780
Mailing Address - Fax:207-985-2933
Practice Address - Street 1:62 PORTLAND RD
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6658
Practice Address - Country:US
Practice Address - Phone:207-985-3780
Practice Address - Fax:207-985-2933
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECR537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME028522Medicare ID - Type Unspecified