Provider Demographics
NPI:1326767567
Name:RADUSZEWSKI, FRANK EDWARD IV
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:EDWARD
Last Name:RADUSZEWSKI
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36602 BERRY CT
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:DE
Mailing Address - Zip Code:19970-3588
Mailing Address - Country:US
Mailing Address - Phone:302-740-3747
Mailing Address - Fax:
Practice Address - Street 1:36602 BERRY CT
Practice Address - Street 2:
Practice Address - City:OCEAN VIEW
Practice Address - State:DE
Practice Address - Zip Code:19970-3588
Practice Address - Country:US
Practice Address - Phone:302-740-3747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer