MEDICARE: FETCH HELP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1518596154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FETCH HELP LLC

Provider Business Mailing Address
First Line	:	500 E 77TH ST APT 1028
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10162-0030
Country	:	US
Telephone Number	:	914-340-4203
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 E 77TH ST APT 1028
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10162-0030
Country	:	US
Telephone Number	:	914-340-4203
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KEVIN FLYNN
Credential	:
Telephone Number	:	914-340-4203

Provider Enumeration Date	:	04/06/2020
Last Update Date	:	05/06/2020

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Directions to “FETCH HELP LLC ” Practice Location

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