Healthcare Provider Details

I. General information

NPI: 1508718123
Provider Name (Legal Business Name): NICOLE EVELYN FALCONE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 OLD COUNTRY RD STE 203
PLAINVIEW NY
11803-4932
US

IV. Provider business mailing address

700 OLD COUNTRY RD STE 203
PLAINVIEW NY
11803-4932
US

V. Phone/Fax

Practice location:
  • Phone: 516-822-9730
  • Fax:
Mailing address:
  • Phone: 516-822-9730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number035295
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number035295
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: