Healthcare Provider Details

I. General information

NPI: 1962420851
Provider Name (Legal Business Name): FRANCINE FRADELLA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 NORTH BROADWAY
NORTH MASSAPEQUA NY
11758
US

IV. Provider business mailing address

747 NORTH BROADWAY
NORTH MASSAPEQUA NY
11758
US

V. Phone/Fax

Practice location:
  • Phone: 516-799-2771
  • Fax: 516-799-2982
Mailing address:
  • Phone: 516-799-2771
  • Fax: 516-799-2982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1899971
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: