Healthcare Provider Details

I. General information

NPI: 1467540302
Provider Name (Legal Business Name): MARTINSVILLE FAMILY PRACTICE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1973 WASHINGTON VALLEY RD
MARTINSVILLE NJ
08836-2053
US

IV. Provider business mailing address

1973 WASHINGTON VALLEY RD
MARTINSVILLE NJ
08836-2053
US

V. Phone/Fax

Practice location:
  • Phone: 732-560-9225
  • Fax: 732-560-8095
Mailing address:
  • Phone: 732-560-9225
  • Fax: 732-560-8095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY FRISOLI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 732-560-9225