Provider Demographics
NPI:1932329745
Name:FALCONE, GEORGE JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JOSEPH
Last Name:FALCONE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 PINE ROAD
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18705-2221
Mailing Address - Country:US
Mailing Address - Phone:570-829-2555
Mailing Address - Fax:570-655-3782
Practice Address - Street 1:2 W WILLIAM ST
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-1838
Practice Address - Country:US
Practice Address - Phone:570-655-2918
Practice Address - Fax:570-655-3782
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA-OE005598-P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11018OtherGEISINGER HEALTH PLAN
PAFA101584OtherBLUE SHIELD
PA391413OtherNATIONAL VISION ADMIN.
PAFA101584OtherBLUE SHIELD
PA10158Medicare ID - Type Unspecified