Provider Demographics
NPI:1821198409
Name:FRATES, ELIZABETH PEGG (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:PEGG
Last Name:FRATES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2718
Mailing Address - Country:US
Mailing Address - Phone:781-431-9783
Mailing Address - Fax:781-431-9783
Practice Address - Street 1:133 LOWELL RD
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2718
Practice Address - Country:US
Practice Address - Phone:781-431-9783
Practice Address - Fax:781-431-9783
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154138208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation