Provider Demographics
NPI:1043253354
Name:JANNOTTA, FRANK SKIFF (MPT)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:SKIFF
Last Name:JANNOTTA
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 EDWARDS MILL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612
Mailing Address - Country:US
Mailing Address - Phone:919-719-3070
Mailing Address - Fax:
Practice Address - Street 1:3001 EDWARDS MILL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5243
Practice Address - Country:US
Practice Address - Phone:919-719-3070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16047225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
K9720001OtherBLUE CROSS BLUE SHIELD
2599650OtherMAMSI
2599650OtherMDIPA
2599650OtherOPTIMUM CHOICE
2599650OtherALLIANCE
2599650OtherALLIANCE