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NPI Code Detail

MEDICARE: AMANDA ANTOINETTE FALCO P.A.

MEDICARE: AMANDA ANTOINETTE FALCO P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant020070NY

General Provider Information

NPI Number : 1497201313
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA ANTOINETTE FALCO P.A.
Provider Business Mailing Address
First Line : 4143 HYLAN BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10308-3308
Country : US
Telephone Number : 718-233-1300
Fax Number :
Provider Business Practice Location Address
First Line : 4143 HYLAN BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10308-3308
Country : US
Telephone Number : 718-233-1300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2016
Last Update Date : 08/31/2016

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