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Individual

MR. FRITZ WENDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
506 MALCOLM X BLVD, NEW YORK, NY 10037-1802
(212) 939-3128
Mailing address
1440 WOOD RD, APT MF, BRONX, NY 10462-7249
(718) 822-0279

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
061202
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
813840
PROVIDER NUMBER CHILD PSY
NY
Enumeration date
01/17/2007
Last updated
07/08/2007
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