Individual
MARIO J FRACASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
732 OLD COUNTRY RD, PLAINVIEW, PLAINVIEW, NY 11803-4929
(516) 822-3911
(516) 822-3983
Mailing address
825 E GATE BLVD STE 111, GARDEN CITY, NY 11530-2136
(516) 804-5200
(516) 240-6540
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
102903
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00178390
—
NY
01
—
CB2940
RAILROAD MEDICARE
NY
Enumeration date
07/07/2005
Last updated
09/09/2019
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