Basic Information
| Provider Information | |||||||||
| NPI: | 1821047333 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FALK | ||||||||
| FirstName: | RALPH | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 TECHNOLOGY DR | ||||||||
| Address2: | |||||||||
| City: | HOOKSETT | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031062504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035806009 | ||||||||
| FaxNumber: | 6035807952 | ||||||||
| Practice Location | |||||||||
| Address1: | 879 LAFAYETTE ROAD | ||||||||
| Address2: | |||||||||
| City: | HAMPTON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039291195 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 03/12/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 7971 | NH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 020473740 | 01 | NH | GREAT WEST HEALTHCARE | OTHER | 466264 | 01 | NH | AETNA | OTHER | 010724YPNH01 | 01 | NH | ANTHEM | OTHER | 110123083 | 01 | NH | RAILROAD MEDICARE | OTHER | 30008701 | 05 | NH | MEDICAID | AA13536 | 01 | NH | HARVARD PILGRIM | OTHER | 020473740 | 01 | NH | TRICARE | OTHER | 020473740 | 01 | NH | PRIVATE HEALTHCARE SYSTEM | OTHER | 020473740 | 01 | NH | UNITED HEALTHCARE | OTHER | 274960 | 01 | NH | CIGNA | OTHER | 020473740 | 01 | NH | HUMANA CHOICE CARE | OTHER | 020473740 | 01 | NH | HEALTHCARE VALUE MGMT | OTHER |