Individual
FRED A HARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
451 CLARKSON AVE, BROOKLYN, NY 11203-2057
(718) 245-3131
Mailing address
1628 LINCOLN PL, 4H, BROOKLYN, NY 11233-5128
(718) 493-9119
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
005377
NY
Other
Enumeration date
03/22/2006
Last updated
08/18/2022
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