Faulkner Medical Laboratories, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

2432 Issued in MA

Legal business name

FAULKNER MEDICAL LABORATORIES, INC.

Practice address

410 Ferry St
Malden, MA 02148-7809

Phone

(781) 322-8502

Fax

(781) 322-8032

NPI assigned

Jul 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Disoungh Timmons

Title

Manager

Phone

(781) 322-8502

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396761680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 FERRY ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021487809",
            "telephone_number": "781-322-8502",
            "fax_number": "781-322-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 FERRY ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021487809",
            "telephone_number": "781-322-8502",
            "fax_number": "781-322-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAULKNER MEDICAL LABORATORIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TIMMONS",
        "authorized_official_first_name": "DISOUNGH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "781-322-8502",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "2432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "228021",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURE HORIZONS",
            "identifier": "801323",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800368",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "801323",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTH NET",
            "identifier": "00000021296",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yi Fan
• Karen Elizabeth Farnsworth, RN
• Christine Farragher
• Ashley Monique Farrar
• Kelly Ryle Farrell
• Nell L. Fay, DPT
• Angela Fazio, MS
• Caitlin Febres-Mazzei, RN
• Sasha Feliciano, FAMILY PARTNER
• Kayra Feliz

• Clinical Medical Laboratory in Malden, MA
• Providers in Malden, MA by specialty
• Clinical Medical Laboratory in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.