| Fredric J Mintz, MD, PC | |
|
175 Jericho Tpke Suite 217 Syosset NY 11791-4532 | |
| (516) 682-0001 | |
| (516) 682-0004 |
| Full Name | Fredric J Mintz, MD, PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 175 Jericho Tpke, Syosset, New York |
| Authorized Official Name and Position | Fredric J Mintz (DOCTOR) |
| Authorized Official Contact | 5166820001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fredric J Mintz, MD, PC 175 Jericho Tpke Suite 217 Syosset NY 11791-4532 Ph: (516) 682-0001 | Fredric J Mintz, MD, PC 175 Jericho Tpke Suite 217 Syosset NY 11791-4532 Ph: (516) 682-0001 |
| NPI Number | 1457534141 |
|---|---|
| Provider Enumeration Date | 12/17/2007 |
| Last Update Date | 12/17/2007 |
| Medicare PECOS PAC ID | 0648352880 |
|---|---|
| Medicare Enrollment ID | O20080128000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457534141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 150334 (New York) | Primary |
| Provider Name | Fredric Mintz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194759530 PECOS PAC ID: 9830271071 Enrollment ID: I20080128000456 |
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