Healthcare Provider Details

I. General information

NPI: 1205765963
Provider Name (Legal Business Name): DONALD FALKOWSKI APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MCKENZIE RD
LOUDON NH
03307-1513
US

IV. Provider business mailing address

5 MCKENZIE RD
LOUDON NH
03307-1513
US

V. Phone/Fax

Practice location:
  • Phone: 603-540-0211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number64481-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number64481-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: