Provider Demographics
NPI:1659377307
Name:LAFAZIA, FRANK W (DO)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:W
Last Name:LAFAZIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-4927
Mailing Address - Country:US
Mailing Address - Phone:401-467-6210
Mailing Address - Fax:401-821-8270
Practice Address - Street 1:37 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-4927
Practice Address - Country:US
Practice Address - Phone:401-467-6210
Practice Address - Fax:401-821-8270
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDO00385207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9003091Medicaid
E75977Medicare UPIN
RI007057924Medicare PIN