Provider Demographics
NPI:1740474576
Name:FRANK J. KILLIAN
Entity type:Organization
Organization Name:FRANK J. KILLIAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:KILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:609-585-3200
Mailing Address - Street 1:2103 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-2641
Mailing Address - Country:US
Mailing Address - Phone:609-585-3200
Mailing Address - Fax:609-586-3186
Practice Address - Street 1:2103 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-2641
Practice Address - Country:US
Practice Address - Phone:609-585-3200
Practice Address - Fax:609-586-3186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD2409213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7418507Medicaid
NJ066771Medicare PIN
NJ7418507Medicaid
NJ1253230001Medicare NSC