Provider Demographics
NPI:1215083365
Name:FRANK DEMENTO, MD & ASSOCIATES,PC
Entity type:Organization
Organization Name:FRANK DEMENTO, MD & ASSOCIATES,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-746-1355
Mailing Address - Street 1:520 FRANKLIN AVE
Mailing Address - Street 2:SUITE 229
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5801
Mailing Address - Country:US
Mailing Address - Phone:516-746-1227
Mailing Address - Fax:516-746-4024
Practice Address - Street 1:520 FRANKLIN AVE
Practice Address - Street 2:SUITE 229
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5801
Practice Address - Country:US
Practice Address - Phone:516-746-1227
Practice Address - Fax:516-746-4024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA64796Medicare UPIN