=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942496260
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRANKLIN J. FRASCO, M.D. PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2007
-----------------------------------------------------
Last Update Date | 09/11/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2051 HIGHWAY 35
-----------------------------------------------------
City | WALL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07719
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-449-7776
-----------------------------------------------------
Fax | 732-449-1338
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2051 HIGHWAY 35
-----------------------------------------------------
City | WALL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07719-3539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-449-7776
-----------------------------------------------------
Fax | 732-449-1338
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VASCULAR SURGEON
-----------------------------------------------------
Name | DR. FRANKLIN J FRASCO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 732-449-7776
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number | 25MA05064500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------