Individual
DORENE CATHERINE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
243 JERICHO TNPK, SYOSSET, NY 11791
(516) 682-8900
(516) 682-8901
Mailing address
724 TOWNE HOUSE VLG, HAUPPAUGE, NY 11749-4819
(631) 232-1994
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F420681
NY
Other
Enumeration date
12/27/2006
Last updated
07/08/2007
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