Individual
DUANE FREDERICKS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 1ST AVE, SK 10S, NEW YORK, NY 10016-6402
(212) 263-3166
Mailing address
530 1ST AVE, SK 10S, NEW YORK, NY 10016-6402
(212) 263-3166
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
25MA08928300
NJ
2083P0901X
Public Health & General Preventive Medicine Physician
25MA08928300
NJ
208600000X
Surgery Physician
P40643
NY
Other
Enumeration date
09/08/2005
Last updated
10/18/2020
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