Healthcare Provider Details
I. General information
NPI: 1679765804
Provider Name (Legal Business Name): JOSEPH LAWRENCE FRENKEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/12/2007
Last Update Date: 06/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5818 HARBOUR VIEW BLVD SUITE B-2
SUFFOLK VA
23435-3315
US
IV. Provider business mailing address
7007 HARBOUR VIEW BLVD SUITE 108
SUFFOLK VA
23435-3657
US
V. Phone/Fax
- Phone: 757-483-3030
- Fax: 757-484-7239
- Phone: 757-215-2784
- Fax: 757-215-2728
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | 0101257817 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: