Provider Demographics
NPI:1295876647
Name:SERRECCHIA, FRANK (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:SERRECCHIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:MS 958
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-7615
Mailing Address - Fax:414-266-6238
Practice Address - Street 1:6125 GREEN BAY RD
Practice Address - Street 2:SUITE 700
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-2928
Practice Address - Country:US
Practice Address - Phone:262-654-8633
Practice Address - Fax:262-654-5461
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI60638208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics