Provider Demographics
NPI:1144423765
Name:FRATES, ANGELA D (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:FRATES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 OLD MARLTON PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8772
Mailing Address - Country:US
Mailing Address - Phone:609-953-3440
Mailing Address - Fax:856-996-4002
Practice Address - Street 1:103 OLD MARLTON PIKE STE 101
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8772
Practice Address - Country:US
Practice Address - Phone:096-953-3440
Practice Address - Fax:856-996-4002
Is Sole Proprietor?:No
Enumeration Date:2007-06-10
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD439658207RG0100X
NJ25MA08967200207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ349765ANKMedicare Oscar/Certification
PA180363FLZMedicare Oscar/Certification