Provider Demographics
NPI:1831228386
Name:FRATERRIGO, PHILIP ANDREW
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ANDREW
Last Name:FRATERRIGO
Suffix:
Gender:M
Credentials:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 MCCLELLAN ST
Mailing Address - Street 2:ST. CLARE'S MEDICAL ARTS BUILDING
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-1019
Mailing Address - Country:US
Mailing Address - Phone:518-382-1130
Mailing Address - Fax:518-382-1173
Practice Address - Street 1:700 MCCLELLAN ST
Practice Address - Street 2:ST. CLARE'S MEDICAL ARTS BUILDING
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-1019
Practice Address - Country:US
Practice Address - Phone:518-382-1130
Practice Address - Fax:518-382-1173
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY217736207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB6992Medicare PIN