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General NPI Number Information
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NPI Number | 1962449959
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Entity Type | Individual
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Provider Name | JOHN THOMAS FRASCA MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 31 PINE ST SUITE 202
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City | NORFOLK
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State | MA
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Zip | 02056-1642
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Country | US
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Telephone | 508-660-1115
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Fax | 508-660-1114
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Provider Business Mailing Address
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Address Line | 31 PINE ST STE 202
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City | NORFOLK
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State | MA
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Zip | 02056-1680
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Country | US
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Telephone | 508-660-1115
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Fax | 508-660-1114
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 58215
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 58215
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License Number State | MA
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