Dr. Jose R Fragoso
Adolescent Medicine
4808 Bergenline Ave 5th Floor
Union City
, New Jersey 07087-5172
Dr. Jose R Fragoso
Adolescent Medicine
4808 Bergenline Ave 5th Floor
Union City
, New Jersey 07087-5172
(201) 865-0038
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Dr. Jose R Fragoso
- 4808 Bergenline Ave 5th Floor
- Union City, NJ
- Zip : 07087-5172
- Fax : (201) 865-0038
- Phone : (201) 865-3444
Second Address
- Dr. Jose R Fragoso
- 4808 Bergenline Ave 5th Floor
- Union City, NJ
- Zip : 07087-5172
- Fax : (201) 865-0038
- Phone : (201) 865-3444
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | 25MA04358900 | NJ |
National Provider Identifier
| NPI | 1164497624 |
|---|---|
| Provider Name | Dr. Jose R Fragoso |
| First Address | Union City, NJ 07087-5172 |
| Second Address | Union City, NJ 07087-5172 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/02/2006 |
| Last Update Date | 04/02/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1140004 | HORIZON NJ HEALTH (01) | NJ |
| 81801 | AMERIGROUP (01) | NH |
| HP080 | OXFORD (01) | NJ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.