Individual
FREDERICK J WERTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
FORDHAM UNIVERSITY, 226B DEALY HALL, BRONX, NY 10458
(718) 817-3778
(718) 817-3785
Mailing address
423 FARRAGUT AVE, HASTINGS ON HUDSON, NY 10706-4037
(914) 478-2050
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
007465-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01449774
—
NY
Enumeration date
05/22/2007
Last updated
07/08/2007
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