Provider Demographics
NPI:1457687287
Name:FRUNCILLO, RICHARD
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:FRUNCILLO
Suffix:
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 1:7 LAKEVIEW PL
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQ
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3940
Mailing Address - Country:US
Mailing Address - Phone:610-368-7201
Mailing Address - Fax:
Practice Address - Street 1:7 LAKEVIEW PL
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQ
Practice Address - State:PA
Practice Address - Zip Code:19073-3940
Practice Address - Country:US
Practice Address - Phone:610-368-7201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023957-E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine