Healthcare Provider Details

I. General information

NPI: 1083624860
Provider Name (Legal Business Name): SANDY J FALK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVE, SHAPIRO 8
BOSTON MA
02215-5491
US

IV. Provider business mailing address

330 BROOKLINE AVE
BOSTON MA
02215-5491
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-4600
  • Fax: 617-667-7493
Mailing address:
  • Phone: 617-667-4600
  • Fax: 617-667-7493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number214136
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: