Healthcare Provider Details

I. General information

NPI: 1912248428
Provider Name (Legal Business Name): FRANK J DEMARIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 03/07/2013
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:
Mailing address:
  • Phone: 631-728-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN 2785
License Number StateNY

VIII. Authorized Official

Name: DR. FRANK DEMARIA
Title or Position: PODIATRIST
Credential: D.P.M.
Phone: 631-728-2424