Provider Demographics
NPI:1043338320
Name:FALCONE, PAUL LOUIS (RPH)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:LOUIS
Last Name:FALCONE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 SERENDIPITY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4363
Mailing Address - Country:US
Mailing Address - Phone:732-905-5275
Mailing Address - Fax:
Practice Address - Street 1:47 SERENDIPITY DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-4363
Practice Address - Country:US
Practice Address - Phone:732-905-5275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02041800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02041800OtherSTATE LICENSE #