Basic Information
Provider Information
NPI: 1427126473
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NELSON
FirstName: FRANK
MiddleName: ANDREW
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 125 CENTRAL AVE
Address2: B9
City: RYE
State: NY
PostalCode: 105801647
CountryCode: US
TelephoneNumber: 9149213166
FaxNumber:  
Practice Location
Address1: 234 E 149TH ST
Address2:  
City: BRONX
State: NY
PostalCode: 104515504
CountryCode: US
TelephoneNumber: 7185795000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/30/2006
LastUpdateDate: 04/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X182875NYY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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