Provider Demographics
NPI:1083899256
Name:FRASCA FOOTCARE PC
Entity Type:Organization
Organization Name:FRASCA FOOTCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:FRASCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-236-4321
Mailing Address - Street 1:6910 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1207
Mailing Address - Country:US
Mailing Address - Phone:718-232-8222
Mailing Address - Fax:718-837-0666
Practice Address - Street 1:1806 BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5705
Practice Address - Country:US
Practice Address - Phone:718-236-4321
Practice Address - Fax:718-232-6800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005015213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4889510002Medicare NSC