MEDICARE: DR. FRANK JAMES LOCCISANO 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
1	207R00000X	Internal Medicine Physician	137271	NY

General Provider Information

NPI Number	:	1235100108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK JAMES LOCCISANO M.D.

Provider Business Mailing Address
First Line	:	50 I U WILLETS RD
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-3038
Country	:	US
Telephone Number	:	516-365-1277
Fax Number	:	516-365-1278

Provider Business Practice Location Address
First Line	:	1115 COLLEGE POINT BLVD
Second Line	:
City	:	COLLEGE POINT
State	:	NY
Zip	:	11356-1727
Country	:	US
Telephone Number	:	718-359-2683
Fax Number	:	516-365-1278

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	07/08/2007

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