MEDICARE: FRANK J. LOCCISANO PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1457531436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANK J. LOCCISANO PC

Provider Business Mailing Address
First Line	:	1115 COLLEGE POINT BLVD
Second Line	:
City	:	COLLEGE POINT
State	:	NY
Zip	:	11356-1727
Country	:	US
Telephone Number	:	718-359-2683
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 COLLEGE POINT BLVD
Second Line	:
City	:	COLLEGE POINT
State	:	NY
Zip	:	11356-1727
Country	:	US
Telephone Number	:	718-359-2683
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. FRANK J LOCCISANO
Credential	:	MD
Telephone Number	:	718-359-2683

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	03/06/2008

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