1992705974 NPI number — DR. JOSEPH FRAGER MD

Table of content: DR. JOSEPH FRAGER MD (NPI 1992705974)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992705974 NPI number — DR. JOSEPH FRAGER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRAGER
Provider First Name:
JOSEPH
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992705974
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
277 VAN CORTLANDT AVE E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10467-3011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-798-8867
Provider Business Mailing Address Fax Number:
718-881-7433

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
277 VAN CORTLANDT AVE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10467-3011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-798-8867
Provider Business Practice Location Address Fax Number:
718-881-7433
Provider Enumeration Date:
07/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  152389-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0036468 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0H1578 . This is a "PHS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: GS035 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0092498 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P2270371 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 27861P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 683547 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 683547 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 152389-A14 . This is a "HEALTH FIRST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 21B591 . This is a "BLUES" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 113093221 . This is a "COMMERCIAL" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1163743-016 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com