Fedrick, Joseph Anthony
Fedrick, Joseph Anthony is an sole proprietor health care provider with primary practice located at 1778 Jerome Ave , Bronx NY 10453-5708. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Fedrick, Joseph Anthony can be contacted via phone (718) 764-1661.Contact Information
Primary practice address
1778 Jerome Ave
Bronx NY 10453-5708
Phone: (718) 764-1661
Fax: (646) 224-1320
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 199200 | New York |
Profile Details
| NPI number | 1629078191 |
|---|---|
| LBN Legal business name | Fedrick, Joseph Anthony |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 27th, 2005 |
| Last updated | Sep 24th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629078191 | NPPES |
| New York | MEDICAID | 01990156 |
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