MEDICARE: CARMEL M FRATIANNI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	036101823	IL

General Provider Information

NPI Number	:	1033106828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEL M FRATIANNI M.D.

Provider Business Mailing Address
First Line	:	1098 W BALTIMORE PIKE STE 3408
Second Line	:
City	:	MEDIA
State	:	PA
Zip	:	19063-5139
Country	:	US
Telephone Number	:	484-234-5000
Fax Number	:	484-234-5001

Provider Business Practice Location Address
First Line	:	1098 W BALTIMORE PIKE STE 3408
Second Line	:
City	:	MEDIA
State	:	PA
Zip	:	19063-5139
Country	:	US
Telephone Number	:	484-234-5000
Fax Number	:	484-234-5001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	07/21/2022

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