Individual
FREDDIERICK REPALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
311 W 35TH ST, NEW YORK, NY 10001-1701
(212) 736-5900
Mailing address
311 W 35TH ST, NEW YORK, NY 10001-1701
(212) 736-5900
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24905
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133952613
—
NY
Enumeration date
09/30/2015
Last updated
09/30/2015
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