Organization
JASON FREDENBERG, PSYCHOLOGIST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON RICHARD FREDENBERG PSYD (PRESIDENT)
(914) 475-7763
Entity
Organization
Contact information
Practice address
370 VIOLET AVE, POUGHKEEPSIE, NY 12601-1034
(914) 475-7763
Mailing address
218 WINDSOR DR, HURLEY, NY 12443-5326
(845) 339-0068
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
015573
NY
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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