Fragoso, Jose R
Fragoso, Jose R is an sole proprietor health care provider with primary practice located at 4808 Bergenline Ave 5Th Floor, Union City NJ 07087-5172. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Fragoso, Jose R can be contacted via phone (201) 865-3444.Contact Information
Primary practice address
4808 Bergenline Ave 5Th Floor
Union City NJ 07087-5172
Phone: (201) 865-3444
Fax: (201) 865-0038
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 25MA04358900 | New Jersey |
Profile Details
| NPI number | 1164497624 |
|---|---|
| LBN Legal business name | Fragoso, Jose R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 20th, 2006 |
| Last updated | Feb 4th, 2021 - about 3 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164497624 | NPPES |
| New Hampshire | Other | 81801 | AMERIGROUP |
| New Hampshire | Other | HP080 | AMERIGROUP |
| New Hampshire | Other | 1140004 | AMERIGROUP |
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