Individual
MARK L FALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 E EVESHAM RD, SUITE F, VOORHEES, NJ 08043-9590
(856) 673-1615
(856) 424-7621
Mailing address
2401 E EVESHAM RD, SUITE F, VOORHEES, NJ 08043-9590
(856) 673-1615
(856) 424-7621
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
25MA06766600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7814402
—
NJ
Enumeration date
04/27/2006
Last updated
06/23/2021
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