Provider Demographics
NPI:1780892109
Name:STEVE FALLEK MD
Entity type:Organization
Organization Name:STEVE FALLEK MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:R
Authorized Official - Last Name:FALLEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-821-7900
Mailing Address - Street 1:300 SYLVAN AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2525
Mailing Address - Country:US
Mailing Address - Phone:201-541-4181
Mailing Address - Fax:
Practice Address - Street 1:1050 WALL ST W
Practice Address - Street 2:STE 360
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-3621
Practice Address - Country:US
Practice Address - Phone:201-821-7900
Practice Address - Fax:201-531-0550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ078327Medicare PIN