Provider Demographics
NPI:1962563635
Name:FALICK, DIANA A (MA)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:A
Last Name:FALICK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W 69 ST 29A
Mailing Address - Street 2:
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5166
Mailing Address - Country:US
Mailing Address - Phone:212-496-8708
Mailing Address - Fax:201-569-8485
Practice Address - Street 1:140 W 69 ST 29A
Practice Address - Street 2:
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10023-5166
Practice Address - Country:US
Practice Address - Phone:212-496-8708
Practice Address - Fax:201-569-8485
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis