Basic Information
| Provider Information | |||||||||
| NPI: | 1891888434 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FALASCA | ||||||||
| FirstName: | GERALD | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 303 MED TECH PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376042391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237943040 | ||||||||
| FaxNumber: | 4237943041 | ||||||||
| Practice Location | |||||||||
| Address1: | 303 MED TECH PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376042391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237943040 | ||||||||
| FaxNumber: | 4237943041 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 03/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | MA47176 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | 46761 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | MD046569L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 110084239 | 01 | NJ | RAILROAD MEDICARE | OTHER | 1245504 | 01 | NJ | UNITED HEALTH CARE | OTHER | 1522113 | 05 | TN | MEDICAID | 3K6156 | 01 | NJ | HEALTHNET, INC | OTHER | 1220802 | 05 | NJ | MEDICAID | 588005 | 01 | NJ | PENNSYLVANIA BLUE SHIELD | OTHER | 84100 | 01 | NJ | AMERIGROUP | OTHER | 123439 | 01 | NJ | AETNA US HEALTHCARE | OTHER | P462113 | 01 | NJ | OXFORD HEALTH PLAN | OTHER | 0409921000 | 01 | NJ | AMERIHEALTH HMO | OTHER | 1015295 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 9037286 | 01 | NJ | CIGNA | OTHER | 13568 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 588005 | 01 | NJ | AMERIHEALTH PPO | OTHER |