Healthcare Provider Details

I. General information

NPI: 1669451811
Provider Name (Legal Business Name): FRANK PAUL LUNATI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2006
Last Update Date: 07/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 LAKE AVE
SAINT JAMES NY
11780-1964
US

IV. Provider business mailing address

116 TERRYVILLE RD
PORT JEFFERSON STATION NY
11776-1329
US

V. Phone/Fax

Practice location:
  • Phone: 631-862-6060
  • Fax:
Mailing address:
  • Phone: 631-928-2002
  • Fax: 631-928-4934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number092615
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: