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Individual

DR. KEITH FRATTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
226 W 238TH ST # A, BRONX, NY 10463-2423
(718) 601-3300
(718) 601-0313
Mailing address
226 W 238TH ST # A, BRONX, NY 10463-2423
(718) 601-3300
(718) 601-0313

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
224858
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02176772
MEDICAID GROUP
NY
05
02366618
NY
Enumeration date
02/20/2006
Last updated
01/12/2018
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