Provider Demographics
NPI:1801419320
Name:NORTH SHORE HEADACHE AND SPINE MEDICAL
Entity Type:Organization
Organization Name:NORTH SHORE HEADACHE AND SPINE MEDICAL
Other - Org Name:FRANK OCASIO MD PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:OCASIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-551-5130
Mailing Address - Street 1:202 E MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-7926
Mailing Address - Country:US
Mailing Address - Phone:631-551-5130
Mailing Address - Fax:631-551-5128
Practice Address - Street 1:202 E MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-7926
Practice Address - Country:US
Practice Address - Phone:631-551-5130
Practice Address - Fax:631-551-5128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty