Healthcare Provider Details

I. General information

NPI: 1982939245
Provider Name (Legal Business Name): JASON FRIGERIO ND, CA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 VILLAGE RD
NEW VERNON NJ
07976-9719
US

IV. Provider business mailing address

PO BOX 107 4 VILLAGE ROAD
NEW VERNON NJ
07976-0107
US

V. Phone/Fax

Practice location:
  • Phone: 973-267-2650
  • Fax: 973-267-2659
Mailing address:
  • Phone: 973-267-2650
  • Fax: 973-267-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00036700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: