Provider Demographics
NPI:1952421885
Name:COLETTA, FRANK SAVERIO (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:SAVERIO
Last Name:COLETTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:200 N VILLAGE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2341
Mailing Address - Country:US
Mailing Address - Phone:516-536-8151
Mailing Address - Fax:516-536-8153
Practice Address - Street 1:200 N VILLAGE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2341
Practice Address - Country:US
Practice Address - Phone:516-536-8151
Practice Address - Fax:516-536-8153
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187532207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG29858Medicare UPIN
NY8N901Medicare ID - Type Unspecified