Provider Demographics
NPI:1295207314
Name:COMMISSO, FRANK JOSEPH (PA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JOSEPH
Last Name:COMMISSO
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:5020 WEEKS LN
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-1350
Mailing Address - Country:US
Mailing Address - Phone:718-423-9536
Mailing Address - Fax:
Practice Address - Street 1:1 DAKOTA DR STE 120
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1136
Practice Address - Country:US
Practice Address - Phone:516-390-2490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY022721363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant