Provider Demographics
NPI:1023119757
Name:ESTELLA, FAUSTINO FALGUI (MD)
Entity type:Individual
Prefix:DR
First Name:FAUSTINO
Middle Name:FALGUI
Last Name:ESTELLA
Suffix:
Gender:M
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:PO BOX 5191
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754-5191
Mailing Address - Country:US
Mailing Address - Phone:732-244-4700
Mailing Address - Fax:732-244-8482
Practice Address - Street 1:111 W WATER ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6407
Practice Address - Country:US
Practice Address - Phone:732-244-4700
Practice Address - Fax:732-244-8482
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03581700208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0106063000OtherPERSONAL CHOICE BCBS
NJ3272401Medicaid
020003621OtherRAILROAD MEDICARE
0106063001OtherAMERIHEALTH
1035428OtherHORIZON NJ HEALTH
403663OtherUHC
457530OtherKEYSTONE
90000661400OtherAMERICHOICE
F11880OtherHEALTHNET
P3165303OtherOXFORD
90000661400OtherAMERICHOICE
NJ3272401Medicaid