Provider Demographics
NPI:1417057464
Name:FRASCA, SANDRO (DPM)
Entity Type:Individual
Prefix:DR
First Name:SANDRO
Middle Name:
Last Name:FRASCA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1207
Mailing Address - Country:US
Mailing Address - Phone:718-232-8222
Mailing Address - Fax:718-837-0666
Practice Address - Street 1:6910 11TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-1207
Practice Address - Country:US
Practice Address - Phone:718-232-8222
Practice Address - Fax:718-837-0666
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005015213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0146324Medicaid
NY0146324Medicaid
U39606Medicare UPIN
NYP61241Medicare ID - Type Unspecified
NYP61241Medicare PIN