Provider Demographics
NPI:1477555415
Name:FALCONE, OVIDIO JOSEPH (DPM, FACFAS)
Entity Type:Individual
Prefix:DR
First Name:OVIDIO
Middle Name:JOSEPH
Last Name:FALCONE
Suffix:
Gender:M
Credentials:DPM, FACFAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2503
Mailing Address - Country:US
Mailing Address - Phone:914-674-1109
Mailing Address - Fax:718-721-3222
Practice Address - Street 1:3501 30TH AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-4662
Practice Address - Country:US
Practice Address - Phone:718-721-9292
Practice Address - Fax:718-721-3222
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN-004171213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01065801Medicaid
NYT51449Medicare UPIN
NYP45531Medicare ID - Type UnspecifiedMEDICARE-BC/BS
NYP45533Medicare ID - Type UnspecifiedMEDICARE-BC/BS
NY23206Medicare ID - Type UnspecifiedMEDICARE-GHI
NYP45532Medicare ID - Type UnspecifiedMEDICARE-BC/BS