Provider Demographics
NPI:1720463177
Name:FALANK, JOSEPH MICHAEL (PA-C, MSPAS)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:FALANK
Suffix:
Gender:M
Credentials:PA-C, MSPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 371
Mailing Address - Street 2:
Mailing Address - City:WEST HYANNISPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02672-0371
Mailing Address - Country:US
Mailing Address - Phone:917-583-8362
Mailing Address - Fax:
Practice Address - Street 1:27 PARK STREET
Practice Address - Street 2:MEDICAL STAFF OFFICE
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-862-7316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA5457363A00000X
NY018849-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant