Provider Demographics
NPI:1861582736
Name:FRAGANO, KAREN M (PA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:FRAGANO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WALL ST
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1447
Mailing Address - Country:US
Mailing Address - Phone:718-904-2400
Mailing Address - Fax:718-904-2827
Practice Address - Street 1:MMC - WEILER DIVISION
Practice Address - Street 2:1825 EASTCHESTER ROAD
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-904-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009789363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant