# FREDRIC J MINTZ, MD, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457534141
- **Authorized official:** DR. FREDRIC J MINTZ MD (DOCTOR)
- **Authorized official phone:** (516) 682-0001

## Contact information

- **Practice address:** 175 JERICHO TPKE, SUITE 217, SYOSSET, NY 11791-4532
- **Practice address phone:** (516) 682-0001
- **Practice address fax:** (516) 682-0004
- **Mailing address:** 175 JERICHO TPKE, SUITE 217, SYOSSET, NY 11791-4532
- **Mailing address phone:** (516) 682-0001
- **Mailing address fax:** (516) 682-0004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 150334 | NY | Yes |

## Other

- **Enumeration date:** 12/17/2007
- **Last updated:** 12/17/2007