Healthcare Provider Details

I. General information

NPI: 1396817268
Provider Name (Legal Business Name): MARIE F. T. FRITZA FIEVRE GARNES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIE F GARNES

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9704 SUTPHIN BLVD
JAMAICA NY
11435-4721
US

IV. Provider business mailing address

60 MADISON AVE 5TH FLOOR
NEW YORK NY
10010-1600
US

V. Phone/Fax

Practice location:
  • Phone: 718-657-7088
  • Fax: 718-657-7092
Mailing address:
  • Phone: 212-545-2439
  • Fax: 646-312-0481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number233833
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: