Fraser, Edward A

Fraser, Edward A is an individual health care provider with primary practice located at 365 Montauk Ave , New London CT 06320-4700. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Fraser, Edward A can be contacted via phone (860) 442-0711.

Contact Information

Primary practice address
365 Montauk Ave New London CT 06320-4700
Phone: (860) 442-0711
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 000391 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 000391 Connecticut

Profile Details

NPI number 1265576508
LBN Legal business name Fraser, Edward A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 19th, 2007
Last updated Jul 9th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265576508 NPPES
Colorado MEDICAID 4041679
Colorado MEDICAID 4024972

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