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NPI Code Detail

MEDICARE: DR. FRANK CERVO M.D.

MEDICARE:  DR. FRANK  CERVO  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician156362NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
254D45OTHERNYEMPIRE BC.BS
35077108OTHERNYAETNA

General Provider Information

NPI Number : 1194750505
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRANK CERVO M.D.
Provider Business Mailing Address
First Line : 100 PATRIOTS RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3318
Country : US
Telephone Number : 631-444-8608
Fax Number : 631-444-8778
Provider Business Practice Location Address
First Line : 100 PATRIOTS RD
Second Line :
City : STONY BROOK
State : NY
Zip : 11790-3318
Country : US
Telephone Number : 631-444-8608
Fax Number : 631-444-8778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 07/16/2010

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Directions to “ DR. FRANK CERVO M.D.” Practice Location

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