MEDICARE: FRITZ JEAN-LOUIS MD

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	2084P0800X	Psychiatry Physician	209748	NY

General Provider Information

NPI Number	:	1982679338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRITZ JEAN-LOUIS MD

Provider Business Mailing Address
First Line	:	10 SUGAR MAPLE DR
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-3207
Country	:	US
Telephone Number	:	516-747-3578
Fax Number	:	516-747-3578

Provider Business Practice Location Address
First Line	:	BROOKDALE HOSPITAL ROCKAWAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212
Country	:	US
Telephone Number	:	718-240-6075
Fax Number	:	718-740-5701

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	11/03/2016

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