Healthcare Provider Details

I. General information

NPI: 1134146764
Provider Name (Legal Business Name): FREDERICK R DOWNS MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4174 ROUTE 98
NORTH JAVA NY
14113
US

IV. Provider business mailing address

4174 ROUTE 98 PO BOX 208
NORTH JAVA NY
14113
US

V. Phone/Fax

Practice location:
  • Phone: 585-535-0051
  • Fax: 585-535-0052
Mailing address:
  • Phone: 585-535-0051
  • Fax: 585-535-0052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. FREDERICK R DOWNS
Title or Position: OWNER
Credential: MD
Phone: 585-535-0051