Provider Demographics
NPI:1669026696
Name:FRATTA, TRICIA MARIE (ATC)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:MARIE
Last Name:FRATTA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 FULTON ST APT 11A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1827
Mailing Address - Country:US
Mailing Address - Phone:917-548-1900
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY PLAZA
Practice Address - Street 2:STEINBERG WELLNESS CENTER - ATHLETICS
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:917-548-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0022992255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer