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Contact Information

RUSSELL FRADKIN, OD
999 PROVIDENCE RD
WHITINSVILLE, MA01588
 Phone: 508-234-6681
 Fax: 508-234-6507
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for RUSSELL FRADKIN · (Male)

NPI # 1114986361
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 03/17/2006
Last updated 03/24/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 2699
  • MA Medicaid 0333913
  • Other 6000000019 HARVARD PILGRIM HEALTHCAR
  • MA Other W15622 BLUE CROSS OF MASS
  • MA Other W20190 BLUE CROSS OF MASS
  • MA Other 725524 TUFTS HEALTH PLAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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