Healthcare Provider Details

I. General information

NPI: 1972779981
Provider Name (Legal Business Name): GARY DAVID FRECHTER PHARMACIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3199 LONG BEACH RD
OCEANSIDE NY
11572-4107
US

IV. Provider business mailing address

659 ARBUCKLE AVE
WOODMERE NY
11598-2701
US

V. Phone/Fax

Practice location:
  • Phone: 516-766-7200
  • Fax: 516-763-1426
Mailing address:
  • Phone: 516-295-3181
  • Fax: 516-295-5839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13869
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number13869
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: