Healthcare Provider Details

I. General information

NPI: 1427770320
Provider Name (Legal Business Name): DEWEY ANTHONY FRECHETTE LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 S MAIN ST
NEW CITY NY
10956-3318
US

IV. Provider business mailing address

3085 WESTON LN
YORKTOWN HEIGHTS NY
10598-1962
US

V. Phone/Fax

Practice location:
  • Phone: 845-204-3834
  • Fax:
Mailing address:
  • Phone: 917-444-2087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007132
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: