MEDICARE: DR. NICHOLAS M FRASCA PHARM.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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RP437935	PA

General Provider Information

NPI Number	:	1689265449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS M FRASCA PHARM.D.

Provider Business Mailing Address
First Line	:	1262 EAGLE RD
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19382-5759
Country	:	US
Telephone Number	:	610-696-4774
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 STEVENS DR
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19113-1532
Country	:	US
Telephone Number	:	215-863-5802
Fax Number	:	215-937-5313

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

Provider Enumeration Date	:	02/03/2021
Last Update Date	:	02/03/2021

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