Healthcare Provider Details

I. General information

NPI: 1346478443
Provider Name (Legal Business Name): FRANK C ANDOLINO D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 06/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 EAST 57 ST SUITE 2600
NEW YORK NY
10022
US

IV. Provider business mailing address

41 EAST 57 ST SUITE 2600
NEW YORK NY
10022
US

V. Phone/Fax

Practice location:
  • Phone: 212-753-5575
  • Fax: 212-826-5060
Mailing address:
  • Phone: 212-753-5575
  • Fax: 212-826-5060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number040 7221
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: