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General NPI Number Information
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NPI Number | 1295207314
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Entity Type | Individual
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Provider Name | FRANK JOSEPH COMMISSO PA
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Gender | Male
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Dates
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Enumeration Date | 12/31/2018
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 1 DAKOTA DR STE 120
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1136
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Country | US
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Telephone | 516-390-2490
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Fax |
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Provider Business Mailing Address
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Address Line | 5020 WEEKS LN
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-1350
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Country | US
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Telephone | 718-423-9536
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 022721
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License Number State | NY
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