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NPI Code Detail

MEDICARE: DR. FRED L HOLTZ PH.D.

MEDICARE: DR. FRED L HOLTZ PH.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
1103T00000XPsychologist010194-1NY

General Provider Information

NPI Number : 1629175039
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRED L HOLTZ PH.D.
Provider Business Mailing Address
First Line : 535 S OYSTER BAY RD
Second Line :
City : PLAINVIEW
State : NY
Zip : 11803-3310
Country : US
Telephone Number : 516-888-4357
Fax Number : 516-513-1456
Provider Business Practice Location Address
First Line : 535 S OYSTER BAY RD
Second Line :
City : PLAINVIEW
State : NY
Zip : 11803-3310
Country : US
Telephone Number : 516-888-4357
Fax Number : 516-513-1456
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 09/27/2024

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