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General NPI Number Information
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NPI Number | 1063657633
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Entity Type | Individual
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Provider Name | JULIE MARISSA FRASCATORE PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 10/11/2018
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Provider Practice Location Address
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Address Line | 43 QUAKER RIDGE RD
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City | SHELTON
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State | CT
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Zip | 06484-2624
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Country | US
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Telephone | 203-944-9609
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Fax |
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Provider Business Mailing Address
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Address Line | 67 MAPLE AVE
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City | DERBY
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State | CT
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Zip | 06418-1328
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Country | US
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Telephone | 203-732-1330
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Fax | 203-732-1332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 001537
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 001537
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License Number State | CT
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