MEDICARE: DR. FREDERICK CARL GARBRECHT M.D.

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
1	208000000X	Pediatrics Physician	158499	NY

General Provider Information

NPI Number	:	1457350134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERICK CARL GARBRECHT M.D.

Provider Business Mailing Address
First Line	:	219 W ALLENS LN
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-4103
Country	:	US
Telephone Number	:	215-248-3535
Fax Number	:

Provider Business Practice Location Address
First Line	:	219 W ALLENS LN
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-4103
Country	:	US
Telephone Number	:	267-234-1114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	10/30/2009

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