Provider Demographics
NPI:1316908676
Name:FRASCO, FRANKLIN J (MD)
Entity type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:J
Last Name:FRASCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3539
Mailing Address - Country:US
Mailing Address - Phone:732-449-7776
Mailing Address - Fax:732-449-1338
Practice Address - Street 1:2051 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-3539
Practice Address - Country:US
Practice Address - Phone:732-449-7776
Practice Address - Fax:732-449-1338
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA050645002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1300407Medicaid
NJ1300407Medicaid
NJC15730Medicare UPIN