Healthcare Provider Details

I. General information

NPI: 1235100108
Provider Name (Legal Business Name): FRANK JAMES LOCCISANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 COLLEGE POINT BLVD
COLLEGE POINT NY
11356-1727
US

IV. Provider business mailing address

50 I U WILLETS RD
ROSLYN NY
11576-3038
US

V. Phone/Fax

Practice location:
  • Phone: 718-359-2683
  • Fax: 516-365-1278
Mailing address:
  • Phone: 516-365-1277
  • Fax: 516-365-1278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number137271
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: