Provider Demographics
NPI:1447489299
Name:FALCO, JAIME ROSE (OD)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:ROSE
Last Name:FALCO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:255 US HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1807
Mailing Address - Country:US
Mailing Address - Phone:732-752-6222
Mailing Address - Fax:732-752-2030
Practice Address - Street 1:255 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812-1807
Practice Address - Country:US
Practice Address - Phone:732-752-6222
Practice Address - Fax:732-752-2030
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00619500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist