Provider Demographics
NPI:1962449959
Name:FRASCA, JOHN THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THOMAS
Last Name:FRASCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 PINE ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1680
Mailing Address - Country:US
Mailing Address - Phone:508-660-1115
Mailing Address - Fax:508-660-1114
Practice Address - Street 1:31 PINE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NORFOLK
Practice Address - State:MA
Practice Address - Zip Code:02056-1642
Practice Address - Country:US
Practice Address - Phone:508-660-1115
Practice Address - Fax:508-660-1114
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA582152086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA17-02018OtherUNITED HEALTH
MA8514OtherHARVARD PILGRIM
MA822787OtherUS HEALTHCARE
MA3028054Medicaid
MA709064OtherTUFTS
MAJ06801OtherBLUE CROSS & BLUE SHIELD
B98080Medicare UPIN
MAJ06801OtherBLUE CROSS & BLUE SHIELD