Provider Demographics
NPI:1003036989
Name:FRISCH, DANIEL ELDON (PTA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ELDON
Last Name:FRISCH
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4506 S ONONDAGA RD
Mailing Address - Street 2:
Mailing Address - City:NEDROW
Mailing Address - State:NY
Mailing Address - Zip Code:13120-9765
Mailing Address - Country:US
Mailing Address - Phone:864-238-5490
Mailing Address - Fax:
Practice Address - Street 1:4506 S ONONDAGA RD
Practice Address - Street 2:
Practice Address - City:NEDROW
Practice Address - State:NY
Practice Address - Zip Code:13120
Practice Address - Country:US
Practice Address - Phone:864-238-5490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1833314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility