Provider Demographics
NPI:1114972528
Name:MONTELEONE, FRANK ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ANTONIO
Last Name:MONTELEONE
Suffix:
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 1:173 MINEOLA BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2528
Mailing Address - Country:US
Mailing Address - Phone:516-741-3560
Mailing Address - Fax:516-741-3562
Practice Address - Street 1:173 MINEOLA BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2528
Practice Address - Country:US
Practice Address - Phone:516-741-3560
Practice Address - Fax:516-741-3562
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123175174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4682H1OtherBLUE CROSS