Provider Demographics
NPI:1801853205
Name:O'FALLON, ERIN COLLEEN (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:COLLEEN
Last Name:O'FALLON
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Gender:F
Credentials:MD MPH
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Mailing Address - Street 1:75 FRANCIS STREET, BRIGHAM AND WOMEN'S HOSPITAL
Mailing Address - Street 2:PBB-B-4-ROOM 428
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-522-6353
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS STREET BRIGHAM AND WOMENS HOSPITAL,
Practice Address - Street 2:PBB-B-4-ROOM 428
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215
Practice Address - Country:US
Practice Address - Phone:617-525-8281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN45268207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNI 17665Medicare UPIN