Healthcare Provider Details

I. General information

NPI: 1568196988
Provider Name (Legal Business Name): REBECCA FRANGIONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 07/12/2022
Certification Date: 07/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 LAKE ST
RAMSEY NJ
07446-2089
US

IV. Provider business mailing address

21 SUNRISE AVE
BLOOMINGDALE NJ
07403-1323
US

V. Phone/Fax

Practice location:
  • Phone: 201-327-1990
  • Fax:
Mailing address:
  • Phone: 973-459-1618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18KT01331600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: