Provider Demographics
NPI:1851307185
Name:CRICCHIO, FRANK PETER (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:PETER
Last Name:CRICCHIO
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 1:20 GRAND ST
Mailing Address - Street 2:FL 3
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-362-1998
Mailing Address - Fax:845-987-5979
Practice Address - Street 1:971 ROUTE 45
Practice Address - Street 2:STE 204
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3500
Practice Address - Country:US
Practice Address - Phone:845-362-1998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine