Provider Demographics
NPI:1972504421
Name:NESTOLA, JOSEPH FRANK (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANK
Last Name:NESTOLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4277 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5709
Mailing Address - Country:US
Mailing Address - Phone:516-731-7770
Mailing Address - Fax:516-731-9038
Practice Address - Street 1:4230 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 205
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5700
Practice Address - Country:US
Practice Address - Phone:516-735-3030
Practice Address - Fax:516-735-3285
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYNY167287207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01199857Medicaid
NY19F371Medicare ID - Type Unspecified
E41147Medicare UPIN