Healthcare Provider Details

I. General information

NPI: 1497798706
Provider Name (Legal Business Name): FRANK WOHLSEIN TELANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 WAVERLY AVE
PATCHOGUE NY
11772-2181
US

IV. Provider business mailing address

8 VERMONT AVE
PORT JEFFERSON STATION NY
11776-6115
US

V. Phone/Fax

Practice location:
  • Phone: 631-758-6445
  • Fax: 631-758-6379
Mailing address:
  • Phone: 631-344-3169
  • Fax: 631-828-2290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number222694
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: