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Individual

DR. THEODORE FALK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
63 GRAND AVE, STE 100, RIVER EDGE, NJ 07661
(201) 487-2900
(201) 487-1022
Mailing address
63 GRAND AVE, STE 100, RIVER EDGE, NJ 07661
(201) 487-2900
(201) 487-1022

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
1375261
NY
207K00000X
Allergy & Immunology Physician
Primary
MA40562
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0910406
NJ
Enumeration date
03/27/2006
Last updated
07/08/2007
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