MEDICARE: DR. JOSEPH FRANK NESTOLA DO

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	NY167287	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972504421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH FRANK NESTOLA DO

Provider Business Mailing Address
First Line	:	4277 HEMPSTEAD TPKE
Second Line	:	SUITE 209
City	:	BETHPAGE
State	:	NY
Zip	:	11714-5709
Country	:	US
Telephone Number	:	516-731-7770
Fax Number	:	516-731-9038

Provider Business Practice Location Address
First Line	:	4230 HEMPSTEAD TPKE
Second Line	:	SUITE 205
City	:	BETHPAGE
State	:	NY
Zip	:	11714-5700
Country	:	US
Telephone Number	:	516-735-3030
Fax Number	:	516-735-3285

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	08/12/2009

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