David J Frederiks (NPI# 1225048168, PAC ID# 6204823172) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1225048168 |
| PAC ID by PECOS | 6204823172 |
| Professional Enrollment ID | I20040430000779 |
| Full Name | David J Frederiks |
| Address |
8 Davis Rd W Old Lyme CT 06371-1448 |
| Gender | M |
| Credential | MD |
| Medical School | UMDNJ-NEW JERSEY MEDICAL SCHOOL |
| Graduation Year | 1995 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 070007 | LAWRENCE & MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 41 Brewster Rd, Bristol, CT 06010-5161 | 8605853000 | HOSPITAL MEDICINE ASSOCIATES LLC |
| 365 Montauk Ave, New London, CT 06320-4700 | 8604420711 | HOSPITAL MEDICINE ASSOCIATES LLC |
| 8 Davis Rd W, Old Lyme, CT 06371-1448 |
| Street Address |
8 DAVIS RD W |
| City | OLD LYME |
| State | CT |
| Zip | 06371-1448 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David F Zita | Psychologist, Clinical | 164 Four Mile River Rd, Old Lyme, CT 06371-1325 | |
| Ann Therese Haydu | Clinical Social Worker | 12 Jericho Dr, Old Lyme, CT 06371-1326 | |
| Vinod V Pathy | Plastic and Reconstructive Surgery | 5 Davis Rd E, Old Lyme, CT 06371-1413 | |
| Jay Graves | Family Medicine | Northeast Medical Group Inc | 19 Halls Rd, Old Lyme, CT 06371-1457 |
| Olaf J Ogland | Psychiatry | 19 Halls Rd, Suite 235, Old Lyme, CT 06371-1457 | |
| Suresh Dmello | Family Medicine | Northeast Medical Group Inc | 19 Halls Rd, Old Lyme, CT 06371-1457 |
| Steven J Difilippo | Clinical Social Worker | 19 Halls Rd, Suite 234, Old Lyme, CT 06371-1457 | |
| Terrence A Doherty | Family Medicine | Northeast Medical Group Inc | 19 Halls Rd, Old Lyme, CT 06371-1457 |
| Christine A Semenza | Optometry | 19 Halls Rd, Suite 210, Old Lyme, CT 06371-1457 | |
| Ellen B Schnier | Clinical Social Worker | 19 Halls Rd, Suite 234, Old Lyme, CT 06371-1457 | |
| Find all physicians in zip 06371 | |||
| City | OLD LYME |
| Zip Code | 06371 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | OLD LYME + FAMILY MEDICINE |
Please comment or provide details below to improve the information on David J Frederiks.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.