Provider Demographics
NPI:1467796151
Name:FRANGEDAKIS, JOSEPH RYAN
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:RYAN
Last Name:FRANGEDAKIS
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 1:1610 3RD CORSO
Mailing Address - Street 2:
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410-2622
Mailing Address - Country:US
Mailing Address - Phone:712-204-2926
Mailing Address - Fax:
Practice Address - Street 1:1610 3RD CORSO
Practice Address - Street 2:
Practice Address - City:NEBRASKA CITY
Practice Address - State:NE
Practice Address - Zip Code:68410-2622
Practice Address - Country:US
Practice Address - Phone:712-204-2926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator