Provider Demographics
NPI:1528091634
Name:PICCIONI, FRANK JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOSEPH
Last Name:PICCIONI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 INNOVATION DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3847
Mailing Address - Country:US
Mailing Address - Phone:757-495-0606
Mailing Address - Fax:
Practice Address - Street 1:516 INNOVATION DR
Practice Address - Street 2:SUITE 103
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3847
Practice Address - Country:US
Practice Address - Phone:757-495-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102037087207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10139414Medicaid
VAC09416Medicare ID - Type Unspecified
VAE83542Medicare UPIN