Healthcare Provider Details

I. General information

NPI: 1023096336
Provider Name (Legal Business Name): FRANK SPINOSA D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2A HUDSON AVENUE
SHELTER ISLAND NY
11964-1023
US

IV. Provider business mailing address

PO BOX 1023 2A HUDSON AVENUE
SHELTER ISLAND NY
11964-1023
US

V. Phone/Fax

Practice location:
  • Phone: 631-749-2222
  • Fax: 631-749-4033
Mailing address:
  • Phone: 631-749-2222
  • Fax: 631-749-4033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN003131
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: