Individual provider Active NPI

Damien Joseph Franolich, ATC

  • Athletic Trainer
  • Kearny, NJ
National Provider Identifier
1497950604
Registry record updated Jul 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
25MT00119100 Issued in NJ
Practice address
295 Ivy St
2ND Floor
Kearny, NJ 07032-3501
Phone
(845) 729-8534
NPI assigned
Jun 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 25MT00119100 NJ Primary

Addresses

Primary practice location

295 Ivy St
2ND Floor
Kearny, NJ 07032-3501

Mailing address

309 Main St
Apt 13
Belleville, NJ 07109-5211
Phone (845) 729-8534

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

LicenseStateTypeSpecialty
25MT00119100NJMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246579200000",
    "number": "1497950604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 MAIN ST",
            "address_2": "APT 13",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071095211",
            "telephone_number": "845-729-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 IVY ST",
            "address_2": "2ND FLOOR",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070323501",
            "telephone_number": "845-729-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANOLICH",
        "first_name": "DAMIEN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2009-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00119100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearny, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.