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General NPI Number Information
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NPI Number | 1306340260
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Entity Type | Organization
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Legal Business Name | FRANKLIN AVENUE MEDICAL PC
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 1075 FRANKLIN AVE
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City | GARDEN CITY
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State | NY
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Zip | 11530-2930
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Country | US
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Telephone | 516-248-1220
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Fax |
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Provider Business Mailing Address
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Address Line | 1075 FRANKLIN AVE
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City | GARDEN CITY
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State | NY
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Zip | 11530-2930
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | RONALD NUZZO
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Credential |
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Telephone | 631-905-5988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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