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Individual

MR. DANIEL J. FRACCHIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
130 CENTER WAY, CORNING, NY 14830-2255
(607) 936-9971
(607) 936-2600
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
009788-1
NY
363A00000X
Physician Assistant
MA003450L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02511388
NY
01
CC8362
RR MEDICARE
NY
01
P00127793
RR MEDICARE PIN
NY
Enumeration date
03/21/2006
Last updated
07/29/2011
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