Active NPI
Laura Fradkin, PT
- Physical Therapist
- Croydon, PA
National Provider Identifier
1023204385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT005593L
- Practice address
- 721 Emily Ave
Croydon, PA 19021-6725 - Phone
- (215) 785-2120
- NPI assigned
- Sep 20, 2007
- Last updated
- Sep 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT005593L | PA | Primary |
Addresses
Primary practice location
721 Emily Ave
Croydon, PA 19021-6725
Mailing address
75 Forsythia Dr E
Levittown, PA 19056-1928
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0019326990002 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT005593L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190246400000",
"number": "1023204385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 FORSYTHIA DR E",
"city": "LEVITTOWN",
"state": "PA",
"postal_code": "190561928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 EMILY AVE",
"city": "CROYDON",
"state": "PA",
"postal_code": "190216725",
"telephone_number": "215-785-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRADKIN",
"first_name": "LAURA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-20",
"last_updated": "2007-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT005593L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0019326990002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Croydon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.