Healthcare Provider Details

I. General information

NPI: 1801817291
Provider Name (Legal Business Name): FRANK JOSEPH DEMARIA D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 W MONTAUK HWY
HAMPTON BAYS NY
11946-4015
US

IV. Provider business mailing address

154 W MONTAUK HWY
HAMPTON BAYS NY
11946-4015
US

V. Phone/Fax

Practice location:
  • Phone: 631-728-2424
  • Fax: 631-325-2240
Mailing address:
  • Phone: 631-728-2424
  • Fax: 631-325-2240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN2785
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: