Provider Demographics
NPI:1851400568
Name:FALK, VIOLETTE (DPM)
Entity Type:Individual
Prefix:
First Name:VIOLETTE
Middle Name:
Last Name:FALK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WRISTON DR
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4819
Mailing Address - Country:US
Mailing Address - Phone:401-274-2477
Mailing Address - Fax:401-861-8952
Practice Address - Street 1:30 WRISTON DR
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4819
Practice Address - Country:US
Practice Address - Phone:401-274-2477
Practice Address - Fax:401-861-8952
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDPM00254213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9007050Medicaid
RI409018OtherBLUE CHIP PROVIDER NUMBER
RI9007050Medicaid