Provider Demographics
NPI:1871502286
Name:KIRBY FALZON, MARIA D (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:KIRBY FALZON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 NEVINS ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3514
Mailing Address - Country:US
Mailing Address - Phone:617-787-8500
Mailing Address - Fax:617-787-7776
Practice Address - Street 1:11 NEVINS ST
Practice Address - Street 2:SUITE 302
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3514
Practice Address - Country:US
Practice Address - Phone:617-787-8500
Practice Address - Fax:617-787-7776
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA41507174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA13415OtherHARVARD PILGRIM HEALTH
MA659660OtherCIGNA
MAV02225OtherBLUE CROSS BLUE SHEILD
MA0012300OtherNEIGHBORHOOD HEALTH PLAN
MA041507OtherTUFTS HEALTH PLAN
MA659660OtherCIGNA
MA0012300OtherNEIGHBORHOOD HEALTH PLAN