Healthcare Provider Details

I. General information

NPI: 1346235140
Provider Name (Legal Business Name): SEBASTIAN JOHN FRAZETTA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 PITTSBURGH ST
SPRINGDALE PA
15144-1623
US

IV. Provider business mailing address

846 PITTSBURGH ST
SPRINGDALE PA
15144-1623
US

V. Phone/Fax

Practice location:
  • Phone: 724-274-9440
  • Fax: 724-274-0858
Mailing address:
  • Phone: 724-274-9440
  • Fax: 724-274-0858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC005111L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: