Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 28703 | MA |
NPI | 1013001262 |
---|---|
Provider Name | Dr. Leender Jack Faling |
First Address | Needham, MA 02492-1358 |
Second Address | West Roxbury, MA 02132-4927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A67490 | (02) | MA |