Provider Demographics
NPI:1164535613
Name:MICHAEL FALCONE, MD LLC
Entity Type:Organization
Organization Name:MICHAEL FALCONE, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FALCONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-567-9233
Mailing Address - Street 1:PO BOX 1142
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-5142
Mailing Address - Country:US
Mailing Address - Phone:609-567-9233
Mailing Address - Fax:
Practice Address - Street 1:373 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1135
Practice Address - Country:US
Practice Address - Phone:609-567-9233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8526401Medicaid
NJ082251Medicare ID - Type Unspecified