Provider Demographics
NPI:1245461821
Name:IPPOLITO, FRANK PETER (PT)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:PETER
Last Name:IPPOLITO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 CHELSEA LOOP
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-1729
Mailing Address - Country:US
Mailing Address - Phone:717-464-1044
Mailing Address - Fax:
Practice Address - Street 1:129 CHELSEA LOOP
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-1729
Practice Address - Country:US
Practice Address - Phone:717-464-1044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT009449L171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator