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General NPI Number Information
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NPI Number | 1083990410
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Entity Type | Individual
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Provider Name | MR. DAVID ANDREW FREDA
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Gender | Male
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Dates
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Enumeration Date | 10/31/2011
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Last Update Date | 10/31/2011
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Provider Practice Location Address
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Address Line | 21 WATAUGNA LN
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City | WESTTOWN
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State | NY
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Zip | 10998-2748
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Country | US
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Telephone | 845-672-9253
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Fax |
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Provider Business Mailing Address
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Address Line | 21 WATAUGA LANE
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City | WESTTOWN
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State | NY
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Zip | 10998
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 073712
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License Number State | NY
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