Provider Demographics
NPI:1376500967
Name:FALCONIERO, ROBERT PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PAUL
Last Name:FALCONIERO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:556 EGG HARBOR RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2326
Mailing Address - Country:US
Mailing Address - Phone:856-589-0650
Mailing Address - Fax:856-589-2720
Practice Address - Street 1:556 EGG HARBOR RD
Practice Address - Street 2:SUITE A
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2326
Practice Address - Country:US
Practice Address - Phone:856-589-0650
Practice Address - Fax:856-589-2720
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB04705300207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE59630Medicare UPIN
NJ580820Medicare ID - Type Unspecified