Provider Demographics
NPI:1588996607
Name:FRAZIER MEDICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:FRAZIER MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAWWA
Authorized Official - Middle Name:S
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-980-6868
Mailing Address - Street 1:1432 HYLAN BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1923
Mailing Address - Country:US
Mailing Address - Phone:718-980-6868
Mailing Address - Fax:718-351-0579
Practice Address - Street 1:1432 HYLAN BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1923
Practice Address - Country:US
Practice Address - Phone:718-980-6868
Practice Address - Fax:718-351-0579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty