Healthcare Provider Details

I. General information

NPI: 1225029143
Provider Name (Legal Business Name): FRANK D'OVIDIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FORT WASHINGTON AVE
NEW YORK NY
10032-3729
US

IV. Provider business mailing address

5A MEDICAL PARK DR
POMONA NY
10970-3516
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-3408
  • Fax: 212-305-3474
Mailing address:
  • Phone: 845-362-0075
  • Fax: 845-362-7475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number251341
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: