Healthcare Provider Details

I. General information

NPI: 1295000313
Provider Name (Legal Business Name): FRANK JAMES RACCIO JR. LNHA, PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7003 MAIN ST
STRATFORD CT
06614-1397
US

IV. Provider business mailing address

7003 MAIN ST
STRATFORD CT
06614-1397
US

V. Phone/Fax

Practice location:
  • Phone: 203-375-5894
  • Fax: 203-375-1199
Mailing address:
  • Phone: 203-375-5894
  • Fax: 203-375-1199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number000908
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number1878
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: