Provider Demographics
NPI:1134264526
Name:FRANDINA, JOE
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:
Last Name:FRANDINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 HERTEL AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-2838
Mailing Address - Country:US
Mailing Address - Phone:716-834-3511
Mailing Address - Fax:
Practice Address - Street 1:1480 HERTEL AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-2838
Practice Address - Country:US
Practice Address - Phone:716-834-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003575156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY118627OtherEYEMED
NY00027234901OtherUNIVERA
NY00027234901OtherUNIVERA