Healthcare Provider Details

I. General information

NPI: 1124003355
Provider Name (Legal Business Name): SUZANNE FRASCA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 08/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 PROFESSIONAL VIEW DRIVE BLDG 300
FREEHOLD NJ
07728-7904
US

IV. Provider business mailing address

312 PROFESSIONAL VIEW DRIVE BLDG 300
FREEHOLD NJ
07728-7904
US

V. Phone/Fax

Practice location:
  • Phone: 917-685-2662
  • Fax: 732-866-7962
Mailing address:
  • Phone: 917-685-2662
  • Fax: 732-866-7962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MB09945400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: