Provider Demographics
NPI:1467325951
Name:FRYCZYNSKI, TATE (MOT, OTR)
Entity type:Individual
Prefix:MR
First Name:TATE
Middle Name:
Last Name:FRYCZYNSKI
Suffix:
Gender:M
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42424 N GAVILAN PEAK PKWY UNIT 16206
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3710
Mailing Address - Country:US
Mailing Address - Phone:201-994-9940
Mailing Address - Fax:
Practice Address - Street 1:42424 N GAVILAN PEAK PKWY UNIT 16206
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3710
Practice Address - Country:US
Practice Address - Phone:201-994-9940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist