Provider Demographics
NPI:1710113287
Name:FALCONE, MADINA (MD)
Entity Type:Individual
Prefix:DR
First Name:MADINA
Middle Name:
Last Name:FALCONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-2212
Mailing Address - Country:US
Mailing Address - Phone:860-679-3540
Mailing Address - Fax:860-679-1390
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-2212
Practice Address - Country:US
Practice Address - Phone:860-679-3540
Practice Address - Fax:860-679-1390
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52874207W00000X
MA237265207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0031272Medicare PIN