Provider Demographics
NPI:1235100108
Name:LOCCISANO, FRANK JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JAMES
Last Name:LOCCISANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:50 I U WILLETS RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3038
Mailing Address - Country:US
Mailing Address - Phone:516-365-1277
Mailing Address - Fax:516-365-1278
Practice Address - Street 1:1115 COLLEGE POINT BLVD
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1727
Practice Address - Country:US
Practice Address - Phone:718-359-2683
Practice Address - Fax:516-365-1278
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY137271207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
98030AMedicare ID - Type Unspecified
NYB88880Medicare UPIN