Healthcare Provider Details

I. General information

NPI: 1386627248
Provider Name (Legal Business Name): FRANK FRAIOLI JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 11/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 SANDERSON RD SUITE 206
SMITHFIELD RI
02917-2602
US

IV. Provider business mailing address

41 SANDERSON RD SUITE 206
SMITHFIELD RI
02917-2602
US

V. Phone/Fax

Practice location:
  • Phone: 401-349-2203
  • Fax: 401-349-2408
Mailing address:
  • Phone: 401-349-2203
  • Fax: 401-349-2408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO372
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: