Provider Demographics
NPI:1285824771
Name:FRASCA, MASSIMILIANO (DO)
Entity Type:Individual
Prefix:DR
First Name:MASSIMILIANO
Middle Name:
Last Name:FRASCA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13211 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5110
Mailing Address - Country:US
Mailing Address - Phone:917-674-6788
Mailing Address - Fax:
Practice Address - Street 1:465 SMITHTOWN BLVD
Practice Address - Street 2:NORTH SHORE URGENT CARE
Practice Address - City:NESCONSET
Practice Address - State:NY
Practice Address - Zip Code:11767-2421
Practice Address - Country:US
Practice Address - Phone:631-676-6700
Practice Address - Fax:631-676-6708
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260484207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine