MEDICARE: ELLEN FRAINT MD

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	208000000X	Pediatrics Physician	289828-01	NY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2080P0207X	Pediatric Hematology & Oncology Physician	289828-01	NY

General Provider Information

NPI Number	:	1215356712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN FRAINT MD

Provider Business Mailing Address
First Line	:	3411 WAYNE AVE FL 9
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2552
Country	:	US
Telephone Number	:	718-741-2342
Fax Number	:

Provider Business Practice Location Address
First Line	:	3411 WAYNE AVE FL 9
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2552
Country	:	US
Telephone Number	:	718-741-2342
Fax Number	:

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

Provider Enumeration Date	:	04/11/2014
Last Update Date	:	06/18/2021

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