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NPI Code Detail

MEDICARE: DR. RESA FREMED EDD LMFT

MEDICARE:  DR. RESA  FREMED  EDD LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist000281NY
2106H00000XMarriage & Family Therapist000499CT

General Provider Information

NPI Number : 1073670162
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RESA FREMED EDD LMFT
Provider Business Mailing Address
First Line : 65 LAKE SHORE DRIVE
Second Line :
City : SOUTH SALEM
State : NY
Zip : 10590-1311
Country : US
Telephone Number : 914-763-3546
Fax Number : 914-514-8074
Provider Business Practice Location Address
First Line : 65 LAKE SHORE DRIVE
Second Line :
City : SOUTH SALEM
State : NY
Zip : 10590-1311
Country : US
Telephone Number : 914-763-3546
Fax Number : 914-514-8074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 07/08/2007

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Directions to “ DR. RESA FREMED EDD LMFT” Practice Location

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