Provider Demographics
NPI:1356497598
Name:FRIEDERWITZER, KARIN (MD)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:FRIEDERWITZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CROSS RD
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2002
Mailing Address - Country:US
Mailing Address - Phone:914-479-1044
Mailing Address - Fax:
Practice Address - Street 1:99 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4655
Practice Address - Country:US
Practice Address - Phone:212-342-0207
Practice Address - Fax:212-342-0200
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2133172084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2109199Medicaid
NY2109199Medicaid
NY071BX1Medicare ID - Type Unspecified