Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 122364-1 | NY |
NPI | 1023072949 |
---|---|
Provider Name | Dr. Philip Carmine Fracassa |
First Address | Franklin Square, NY 11010-1227 |
Second Address | Franklin Square, NY 11010-1227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 02/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0094688 | GHI (01) | NY |
112526966 | UNITED HEALTH CARE (01) | NY |
25403P | HIP (01) | NY |
320111 | BLUE CROSS/BUE SHIELD (01) | NY |
660440 | HEALTHCARE PARTNERS (01) | NY |
884939 | AETNA (01) | NY |
AS639 | OXFORD HEALTH PLANS (01) | NY |
B12960 | (02) | NY |