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General NPI Number Information
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NPI Number | 1932065844
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Entity Type | Individual
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Provider Name | MATTHEW FRAHER
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Gender | Male
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 220 HEBERTON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10302-1415
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Country | US
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Telephone | 718-448-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 220 HEBERTON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10302-1415
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Country | US
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Telephone | 718-448-1900
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | N15004-01
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License Number State | NY
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