Individual
DR. MARK ANTHONY FRATTALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 LACKAWANNA AVE STE 200, SCRANTON, PA 18503-2001
(570) 342-7864
(570) 840-1259
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD046121L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001469575001
—
PA
Enumeration date
07/27/2005
Last updated
12/30/2021
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