Organization
JOSE FRAGOSO MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE FRAGOSO MD (DOCTOR)
(732) 281-3590
Entity
Organization
Contact information
Practice address
4808 BERGENLINE AVE, UNION CITY, NJ 07087-5172
(732) 281-3590
(732) 281-0054
Mailing address
4808 BERGENLINE AVE, UNION CITY, NJ 07087-5172
(732) 281-3590
(732) 281-0054
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MAO43589
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2062208
—
NJ
Enumeration date
05/04/2007
Last updated
08/22/2020
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