Provider Demographics
NPI:1396788410
Name:CIMINIELLO, FRANK ANGELO (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ANGELO
Last Name:CIMINIELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:112 QUARRY RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4816
Mailing Address - Country:US
Mailing Address - Phone:203-374-6162
Mailing Address - Fax:203-374-1549
Practice Address - Street 1:112 QUARRY RD
Practice Address - Street 2:SUITE 220
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4816
Practice Address - Country:US
Practice Address - Phone:203-374-6162
Practice Address - Fax:203-374-1549
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101502476Medicaid
PA101502476Medicaid
I48510Medicare UPIN