Organization
RUSSELL & JANE FRADKIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL FRADKIN (OD OWNER)
(508) 234-6681
Entity
Organization
Contact information
Practice address
999 PROVIDENCE RD, WHITINSVILLE, MA 01588-2123
(508) 234-6681
(508) 234-6507
Mailing address
999 PROVIDENCE RD, WHITINSVILLE, MA 01588-2123
(508) 234-6681
(508) 234-6507
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W20190
BC/BS
MA
Enumeration date
01/26/2007
Last updated
11/13/2017
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