Healthcare Provider Details

I. General information

NPI: 1386812733
Provider Name (Legal Business Name): FRANCES C FITTANTO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 MONMOUTH RD BUILDING B SUITE 5
OAKHURST NJ
07755-1500
US

IV. Provider business mailing address

257 MONMOUTH RD BUILDING B SUITE 5
OAKHURST NJ
07755-1500
US

V. Phone/Fax

Practice location:
  • Phone: 973-839-1003
  • Fax: 973-839-3653
Mailing address:
  • Phone: 973-839-1003
  • Fax: 973-839-3653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00194000
License Number StateNJ

VIII. Authorized Official

Name: FRANCES C FITTANTO
Title or Position: DOCTOR
Credential: DPM
Phone: 973-839-1003