Provider Demographics
NPI:1578343521
Name:FRALICK, MARY (FPA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:
Last Name:FRALICK
Suffix:
Gender:F
Credentials:FPA-C
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:R
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:242 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2527
Mailing Address - Country:US
Mailing Address - Phone:607-433-2343
Mailing Address - Fax:607-432-5516
Practice Address - Street 1:242 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2527
Practice Address - Country:US
Practice Address - Phone:607-433-2343
Practice Address - Fax:607-432-5516
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist