Provider Demographics
NPI:1457469090
Name:FRANK, OLEG (MD)
Entity Type:Individual
Prefix:DR
First Name:OLEG
Middle Name:
Last Name:FRANK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 FERRY ST
Mailing Address - Street 2:REAR
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-1432
Mailing Address - Country:US
Mailing Address - Phone:973-344-4470
Mailing Address - Fax:973-344-4476
Practice Address - Street 1:40 FERRY ST
Practice Address - Street 2:REAR
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-1432
Practice Address - Country:US
Practice Address - Phone:973-344-4470
Practice Address - Fax:973-344-4476
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA073494207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8773602Medicaid
NJ8773602Medicaid
NJ069572Medicare ID - Type UnspecifiedINTERNAL MEDICINE