Provider Demographics
NPI:1699525485
Name:FRAZIER, BLANCHE L
Entity type:Individual
Prefix:
First Name:BLANCHE
Middle Name:L
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 VOSSELLER AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-2294
Mailing Address - Country:US
Mailing Address - Phone:201-538-4531
Mailing Address - Fax:
Practice Address - Street 1:143 VOSSELLER AVE FL 1
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-2294
Practice Address - Country:US
Practice Address - Phone:201-538-4531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child