Healthcare Provider Details

I. General information

NPI: 1023119757
Provider Name (Legal Business Name): FAUSTINO FALGUI ESTELLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W WATER ST
TOMS RIVER NJ
08753-6407
US

IV. Provider business mailing address

PO BOX 5191
TOMS RIVER NJ
08754-5191
US

V. Phone/Fax

Practice location:
  • Phone: 732-244-4700
  • Fax: 732-244-8482
Mailing address:
  • Phone: 732-244-4700
  • Fax: 732-244-8482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA03581700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: