Fraccola, Philip J.

Fraccola, Philip J. is an individual health care provider with primary practice located at 5100 W Taft Rd Suite 2A, Liverpool NY 13088-3807. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Fraccola, Philip J. can be contacted via phone (315) 452-2555.

Contact Information

Primary practice address
5100 W Taft Rd Suite 2A Liverpool NY 13088-3807
Phone: (315) 452-2555
Fax: (315) 452-2559
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME147948 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 173758 New York

Profile Details

NPI number 1699767707
LBN Legal business name Fraccola, Philip J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Mar 6th, 2024 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699767707 NPPES
New York MEDICAID 01334321
New York MEDICAID 02224500
New York MEDICAID 00555500
New York MEDICAID 00555440

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