Provider Demographics
NPI:1043212350
Name:PINTO, FRANK JOHN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOHN
Last Name:PINTO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 MAIN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-1080
Mailing Address - Country:US
Mailing Address - Phone:203-810-4151
Mailing Address - Fax:203-810-4150
Practice Address - Street 1:761 MAIN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1080
Practice Address - Country:US
Practice Address - Phone:203-810-4151
Practice Address - Fax:203-810-4150
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044059207N00000X, 207ND0101X, 207NS0135X
CT47442207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00766994AMedicaid
GA00766994GMedicaid
GA00766994BMedicaid
GAGRP4818Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
GA07BBCRXMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
GA00766994AMedicaid
CTD400003777Medicare PIN