Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 188141 | NY |
NPI | 1003855263 |
---|---|
Provider Name | Dr. Loriann Fraas |
First Address | Amherst, NY 14226-1631 |
Second Address | Tonawanda, NY 14150 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 21/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010057401 | UNIVERA (01) | |
000523032003 | BCBS CB (01) | |
0086173 | GHI (01) | |
01480437 | (05) | NY |
0708467 | INDEPENDENT HEALTH (01) | |
156783CK | PREFERRED CARE (01) | |
1574 | UNIVERA PIN (01) | |
160032992 | RAILROAD BLOCK 24K (01) | |
188141 | NYS LICENSE (01) | |
BF3607922 | DEA (01) | |
F72502 | (02) |