Individual
MRS. DESIREE FEDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
SUNY STONY BROOK HOSPITAL, 101 NICHOLS ROAD, STONY BROOK, NY 11794-0001
(631) 638-0693
(631) 638-0660
Mailing address
STONY BROOK CANCER CTR, 9445 SUNY 9460, STONY BROOK, NY 11794-9460
(631) 638-0693
(631) 638-0660
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306194-1
NY
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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