=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376789271
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRANK P LUNATI JR MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/23/2008
-----------------------------------------------------
Last Update Date | 03/10/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 70 N COUNTRY RD SUITE 201
-----------------------------------------------------
City | PORT JEFFERSON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11777-2161
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-403-4310
-----------------------------------------------------
Fax | 631-403-4312
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 70 N COUNTRY RD SUITE 201
-----------------------------------------------------
City | PORT JEFFERSON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11777-2161
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-403-4310
-----------------------------------------------------
Fax | 631-403-4312
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICER
-----------------------------------------------------
Name | DR. FRANK PAUL LUNATI JR.
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 631-403-4310
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 237608
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------