Provider Demographics
NPI:1407006299
Name:JEFFREY J. FALCONE, DPM, PC
Entity Type:Organization
Organization Name:JEFFREY J. FALCONE, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FALCONE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-838-4151
Mailing Address - Street 1:622 76TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3326
Mailing Address - Country:US
Mailing Address - Phone:212-838-4151
Mailing Address - Fax:718-492-9191
Practice Address - Street 1:622 76TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3326
Practice Address - Country:US
Practice Address - Phone:212-838-4151
Practice Address - Fax:719-492-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004972213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01525846Medicaid
NYP60021Medicare PIN
NY01525846Medicaid