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General NPI Number Information
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NPI Number | 1588206080
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Entity Type | Individual
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Provider Name | HALEY FRATI PA
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Gender | Female
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Dates
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Enumeration Date | 10/16/2019
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 19 DAVIS AVE
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City | NEPTUNE
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State | NJ
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Zip | 07753-4488
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Country | US
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Telephone | 302-521-9884
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Fax |
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Provider Business Mailing Address
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Address Line | 14 COUNTY ROAD 618
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City | LEBANON
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State | NJ
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Zip | 08833-3026
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Country | US
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Telephone |
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00545000
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License Number State | NJ
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