Provider Demographics
NPI:1508853763
Name:KILLIAN, FRANK JOHN (DPM)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JOHN
Last Name:KILLIAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:202 ROUTE 37 W
Mailing Address - Street 2:STE 4
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8055
Mailing Address - Country:US
Mailing Address - Phone:732-557-4266
Mailing Address - Fax:732-557-5001
Practice Address - Street 1:202 ROUTE 37 W
Practice Address - Street 2:STE 4
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8055
Practice Address - Country:US
Practice Address - Phone:609-585-3200
Practice Address - Fax:609-586-3186
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMD002409213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7418507Medicaid
NJ7418507Medicaid
NJ1253230001Medicare NSC
NJ960075REUMedicare PIN