Individual
DR. MARIO RICHARD FRAGALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
163 WICKS LN, MALVERNE, NY 11565-2217
(516) 593-4758
Mailing address
163 WICKS LN, MALVERNE, NY 11565-2217
(516) 593-4758
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
104574-1
NY
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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