Basic Information
Provider Information
NPI: 1164789244
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FALK
FirstName: NADJA
MiddleName: K
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3374 STATE STREET DR
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701254245
CountryCode: US
TelephoneNumber: 8323305760
FaxNumber:  
Practice Location
Address1: 2211 LOMAS BLVD NE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871062719
CountryCode: US
TelephoneNumber: 5052721111
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/13/2012
LastUpdateDate: 05/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZC0500XMD.208040LAN Allopathic & Osteopathic PhysiciansPathologyCytopathology
207ZC0500XM9182TXN Allopathic & Osteopathic PhysiciansPathologyCytopathology
207ZP0101XMD2019-0115NMY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
207ZP0101XMD.208040LAN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
207ZP0101XM9182TXN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology

No ID Information.


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