Individual
DR. JOSE R FRAGOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4808 BERGENLINE AVE, 5TH FLOOR, UNION CITY, NJ 07087-5172
(201) 865-3444
(201) 865-0038
Mailing address
4808 BERGENLINE AVE, 5TH FLOOR, UNION CITY, NJ 07087-5172
(201) 865-3444
(201) 865-0038
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
25MA04358900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1140004
HORIZON NJ HEALTH
NJ
01
—
81801
AMERIGROUP
NH
01
—
HP080
OXFORD
NJ
Enumeration date
02/20/2006
Last updated
02/04/2021
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