Active NPI
Renee Rachelle Fragoman, B.S.
- Physical Therapist
- Geneseo, NY
National Provider Identifier
1497077549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 019079
- Practice address
- 1 College Cir
Suny Geneseo - Holcomb Building
Geneseo, NY 14454-1401 - Phone
- (585) 245-5688
- Fax
- (585) 245-5685
- NPI assigned
- Feb 17, 2010
- 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 | 019079 | NY | Primary |
Addresses
Primary practice location
1 College Cir
Suny Geneseo - Holcomb Building
Geneseo, NY 14454-1401
Mailing address
1 College Cir
Suny Geneseo - Holcomb Building
Geneseo, NY 14454-1401
Phone (585) 245-5688
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019079 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266364800000",
"number": "1497077549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 COLLEGE CIR",
"address_2": "SUNY GENESEO - HOLCOMB BUILDING",
"city": "GENESEO",
"state": "NY",
"postal_code": "144541401",
"telephone_number": "585-245-5688",
"fax_number": "585-245-5685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 COLLEGE CIR",
"address_2": "SUNY GENESEO - HOLCOMB BUILDING",
"city": "GENESEO",
"state": "NY",
"postal_code": "144541401",
"telephone_number": "585-245-5688",
"fax_number": "585-245-5685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAGOMAN",
"first_name": "RENEE",
"middle_name": "RACHELLE",
"name_prefix": "Mrs.",
"credential": "B.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-17",
"last_updated": "2010-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "019079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Geneseo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.