Healthcare Provider Details

I. General information

NPI: 1255379251
Provider Name (Legal Business Name): FRITZ CADET CSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 E 23RD ST NEW YORK HARBOR HEALTHCARE SYSTEM
NEW YORK NY
10010-5011
US

IV. Provider business mailing address

629 W 115TH ST 2-C
NEW YORK NY
10025-7779
US

V. Phone/Fax

Practice location:
  • Phone: 212-686-7500
  • Fax:
Mailing address:
  • Phone: 212-686-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number024155-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: