Provider Demographics
NPI:1366008120
Name:AMY MARIE FALCONE-WHARTON MD PC
Entity Type:Organization
Organization Name:AMY MARIE FALCONE-WHARTON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-712-4869
Mailing Address - Street 1:1701 N GREEN VALLEY PKWY BLDG 3
Mailing Address - Street 2:STE B
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5885
Mailing Address - Country:US
Mailing Address - Phone:702-737-3200
Mailing Address - Fax:702-369-4727
Practice Address - Street 1:1701 N GREEN VALLEY PKWY BLDG 3
Practice Address - Street 2:STE B
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5885
Practice Address - Country:US
Practice Address - Phone:702-737-3200
Practice Address - Fax:702-369-4727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty