Provider Demographics
NPI:1922051267
Name:FRATELLONE MEDICAL ASSOCIATES, LLP
Entity Type:Organization
Organization Name:FRATELLONE MEDICAL ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, DIRECTOR OF BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-421-3202
Mailing Address - Street 1:47 W 57TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3401
Mailing Address - Country:US
Mailing Address - Phone:212-421-3202
Mailing Address - Fax:212-421-7207
Practice Address - Street 1:47 W 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3401
Practice Address - Country:US
Practice Address - Phone:212-421-3202
Practice Address - Fax:212-421-7207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP3612433OtherOXFORD HEALTH PLANS
NYWEW931Medicare ID - Type Unspecified