Provider Demographics
NPI:1396721833
Name:NATALE, FRANCES O (DO)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:O
Last Name:NATALE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-5555
Mailing Address - Country:US
Mailing Address - Phone:860-533-4666
Mailing Address - Fax:860-533-4667
Practice Address - Street 1:2400 TAMARACK RD
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-5555
Practice Address - Country:US
Practice Address - Phone:860-533-4666
Practice Address - Fax:860-533-4667
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000391207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001003912Medicaid
080079959Medicare PIN
CT001003912Medicaid
CT080000845Medicare PIN