Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 188921 | NY |
NPI | 1033183199 |
---|---|
Provider Name | Mr. Frank Anthony Starvaggi |
First Address | Middletown, NY 10940-4133 |
Second Address | Middletown, NY 10940-4133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 07/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01355366 | (05) | NY |
F31190 | (02) |