Provider Demographics
NPI:1093765414
Name:FALCIANI, AMERIGO (DO)
Entity Type:Individual
Prefix:
First Name:AMERIGO
Middle Name:
Last Name:FALCIANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 W JIMMIE LEEDS RD
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9406
Mailing Address - Country:US
Mailing Address - Phone:609-677-9729
Mailing Address - Fax:
Practice Address - Street 1:219 N WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1896
Practice Address - Country:US
Practice Address - Phone:609-677-9729
Practice Address - Fax:609-652-6270
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB063171002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00401584OtherRAILROAD MEDICARE
NJP00801053OtherRAILROAD MEDICARE
NJP00758313OtherRAILROAD MEDICARE
NJ0097365Medicaid
NJ099984AMLMedicare PIN
G74709Medicare UPIN
NJ099984ZDDPMedicare PIN
NJP00801053OtherRAILROAD MEDICARE