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General NPI Number Information
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NPI Number | 1083899256
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Entity Type | Organization
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Legal Business Name | FRASCA FOOTCARE PC
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 1806 BAY RIDGE PKWY
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City | BROOKLYN
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State | NY
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Zip | 11204-5705
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Country | US
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Telephone | 718-236-4321
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Fax | 718-232-6800
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Provider Business Mailing Address
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Address Line | 6910 11TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11228-1207
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Country | US
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Telephone | 718-232-8222
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Fax | 718-837-0666
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Authorized Official
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Title or Position | OWNER
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Name | SANDRO FRASCA
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Credential |
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Telephone | 718-236-4321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | N005015
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License Number State | NY
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