Provider Demographics
NPI:1619202983
Name:MACCARELLI, FRANK J SR (NAVY IDC)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:J
Last Name:MACCARELLI
Suffix:SR
Gender:M
Credentials:NAVY IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1573 GALLERY AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-5669
Mailing Address - Country:US
Mailing Address - Phone:757-301-2988
Mailing Address - Fax:
Practice Address - Street 1:USS SAN JACINTO CG-56
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09587-1176
Practice Address - Country:US
Practice Address - Phone:757-444-3069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman