Provider Demographics
NPI:1467540302
Name:MARTINSVILLE FAMILY PRACTICE PA
Entity Type:Organization
Organization Name:MARTINSVILLE FAMILY PRACTICE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRISOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-560-9225
Mailing Address - Street 1:1973 WASHINGTON VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08836-2053
Mailing Address - Country:US
Mailing Address - Phone:732-560-9225
Mailing Address - Fax:732-560-8095
Practice Address - Street 1:1973 WASHINGTON VALLEY RD
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08836-2053
Practice Address - Country:US
Practice Address - Phone:732-560-9225
Practice Address - Fax:732-560-8095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty