Active NPI
Frank J Demento, MD
- Dermatology Physician
- Garden City, NY
National Provider Identifier
1093788416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 093163
- Practice address
- 520 Franklin Avenue
Suite 229
Garden City, NY 11530-5878 - Phone
- (516) 746-1227
- Fax
- (516) 746-4024
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 093163 | NY | Primary |
| Dermatology Physician | 207N00000X | ME26062 | FL |
Addresses
Primary practice location
520 Franklin Avenue
Suite 229
Garden City, NY 11530-5878
Mailing address
520 Franklin Avenue
Suite 229
Garden City, NY 11530-5878
Phone (516) 746-1227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 093163 | NY | MD | Clinical Social Worker |
| ME26062 | FL | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268265600000",
"number": "1093788416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 FRANKLIN AVENUE",
"address_2": "SUITE 229",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115305878",
"telephone_number": "516-746-1227",
"fax_number": "516-746-4024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 FRANKLIN AVENUE",
"address_2": "SUITE 229",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115305878",
"telephone_number": "516-746-1227",
"fax_number": "516-746-4024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMENTO",
"first_name": "FRANK",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2010-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "093163",
"primary": true
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "FL",
"license": "ME26062",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.