Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 11150 | MN |
Y | 213EG0000X | General Practice | 11150 | MN |
NPI | 1003039595 |
---|---|
Provider Name | Dr. Neda Falak |
First Address | Eagan, MN 55123-1199 |
Second Address | Eagan, MN 55123-1199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |