Provider Demographics
NPI:1669416012
Name:FALCONE, EMANUEL J (MD)
Entity type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:J
Last Name:FALCONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:11124 SEA TROPIC LN
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-8285
Mailing Address - Country:US
Mailing Address - Phone:239-482-1436
Mailing Address - Fax:239-267-9713
Practice Address - Street 1:11124 SEA TROPIC LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-8285
Practice Address - Country:US
Practice Address - Phone:239-482-1436
Practice Address - Fax:239-267-9713
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1634012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02296380Medicaid
NYF20789Medicare UPIN
NY16G761Medicare ID - Type Unspecified