EDWARD A FRASER PA-C NPI 1265576508

NPI Information

  • NPI: 1265576508
  • Provider Name: EDWARD A FRASER, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 365 MONTAUK AVE
    NEW LONDON, CT
    ZIP 06320
  • Phone: (860) 442-0711

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NPI Details

Edward A Fraser, PA-C is a medical physician assistant in New London, CT. Edward A Fraser, PA-C NPI is 1265576508. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

365 MONTAUK AVE
NEW LONDON, CT
ZIP 06320-700
Phone: (860) 442-0711

The enumeration date for this NPI number is 2/19/2007 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical000391CONNECTICUTYes
2363AS0400XPhysician AssistantSurgical000391CONNECTICUTNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14041679MEDICAIDCOLORADO
24024972MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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