Provider Demographics
NPI:1093139164
Name:AMADIO, FRANK R JR (MSED)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:R
Last Name:AMADIO
Suffix:JR
Gender:M
Credentials:MSED
Other - Prefix:MR
Other - First Name:FRANK
Other - Middle Name:R
Other - Last Name:AMADIO
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MSED
Mailing Address - Street 1:80 HIGHFIELD LN
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1930
Mailing Address - Country:US
Mailing Address - Phone:973-255-8647
Mailing Address - Fax:
Practice Address - Street 1:80 HIGHFIELD LN
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1930
Practice Address - Country:US
Practice Address - Phone:973-255-8647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000769-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer