MRS. Benita Fredrick, PTA

NPI #1902813926 in Freeport, New York

Provider Information

NPI Number: 1902813926
Entity Type: Individual
Name: MRS. Benita Fredrick, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: PTA
Enumeration Date: Aug 2, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 49 CHURCH ST
City: Freeport
State: New York
ZIP Code: 11520-3830
Phone: (516) 623-6253

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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