Provider Demographics
NPI:1407128986
Name:FRASCARELLI, MARTHA JEAN
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:JEAN
Last Name:FRASCARELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29217 FORD RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2889
Mailing Address - Country:US
Mailing Address - Phone:734-338-9281
Mailing Address - Fax:
Practice Address - Street 1:29217 FORD RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2889
Practice Address - Country:US
Practice Address - Phone:734-338-9281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health