Healthcare Provider Details
I. General information
NPI: 1336233352
Provider Name (Legal Business Name): SARAJO BUNNY FALK PSY.D.PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3410 ROSE HILL WAY
LAUDERHILL FL
33319-5130
US
IV. Provider business mailing address
PO BOX 934068
MARGATE FL
33093-4068
US
V. Phone/Fax
- Phone: 954-731-0690
- Fax: 954-366-2056
- Phone: 954-366-2700
- Fax: 954-366-2056
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY5737 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: