Provider Demographics
NPI:1558062695
Name:FRASCA, DORIS
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:FRASCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 MARKET ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-4636
Mailing Address - Country:US
Mailing Address - Phone:215-287-2114
Mailing Address - Fax:
Practice Address - Street 1:4601 MARKET ST FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-4636
Practice Address - Country:US
Practice Address - Phone:215-287-2114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN745404163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse