Provider Demographics
NPI:1124003355
Name:FRASCA, SUZANNE (DO)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:FRASCA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 PROFESSIONAL VIEW DR
Mailing Address - Street 2:BLDG 300
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-7904
Mailing Address - Country:US
Mailing Address - Phone:732-431-1616
Mailing Address - Fax:732-984-9806
Practice Address - Street 1:10 UNION SQ E
Practice Address - Street 2:BIMC DEPT OF OBGYN, SUITE 2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3314
Practice Address - Country:US
Practice Address - Phone:212-844-8590
Practice Address - Fax:212-844-8501
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB09945400207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02377723Medicaid
I44927Medicare UPIN
NY812C61Medicare ID - Type Unspecified