Provider Demographics
NPI:1356523096
Name:FRAUSTO, FRANK L (RPT)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:L
Last Name:FRAUSTO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BALD HILL RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1617
Mailing Address - Country:US
Mailing Address - Phone:401-737-3934
Mailing Address - Fax:401-737-1276
Practice Address - Street 1:400 BALD HILL RD
Practice Address - Street 2:SUITE 502
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1617
Practice Address - Country:US
Practice Address - Phone:401-737-3934
Practice Address - Fax:401-737-1276
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT 00654225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
659082074OtherMEDICARE GROUP PIN #
659082074OtherMEDICARE GROUP PIN #