Provider Demographics
NPI:1376501825
Name:FALANGA, VINCENT (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:FALANGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 MAIN ST STE 302
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3301
Mailing Address - Country:US
Mailing Address - Phone:978-371-7010
Mailing Address - Fax:978-371-0522
Practice Address - Street 1:1 CITY HALL PLZ
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3149
Practice Address - Country:US
Practice Address - Phone:781-662-8881
Practice Address - Fax:781-662-8886
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH24501207N00000X
FLME32699207N00000X
RI09698207N00000X
MA204639207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9025375Medicaid
RI9025375Medicaid
RID50164Medicare UPIN