Individual
JAMES E FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1427 GENESEE ST, UTICA, NY 13501-4343
(315) 798-8868
(315) 368-0195
Mailing address
9 TOGGLETOWN LN, CLINTON, NY 13323-1561
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
146667
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146667
—
NY
Enumeration date
10/04/2006
Last updated
01/12/2016
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