Provider Demographics
NPI:1598144578
Name:PORTUGAL, FRANK A (DO)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:A
Last Name:PORTUGAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:419 BRICK BLVD
Mailing Address - Street 2:APT 43A
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6046
Mailing Address - Country:US
Mailing Address - Phone:848-448-0070
Mailing Address - Fax:
Practice Address - Street 1:1378 ROUTE 206 STE 6-330
Practice Address - Street 2:
Practice Address - City:SKILLMAN
Practice Address - State:NJ
Practice Address - Zip Code:08558-1923
Practice Address - Country:US
Practice Address - Phone:732-305-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-25
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB10593300207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology