Provider Demographics
NPI:1548475627
Name:SAINT-LOUIS, FRITZ (MD)
Entity type:Individual
Prefix:
First Name:FRITZ
Middle Name:
Last Name:SAINT-LOUIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11723 238TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3930
Mailing Address - Country:US
Mailing Address - Phone:516-491-1617
Mailing Address - Fax:516-837-7574
Practice Address - Street 1:11723 238TH ST
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3930
Practice Address - Country:US
Practice Address - Phone:516-491-1617
Practice Address - Fax:516-837-7574
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1995912080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG10675Medicare UPIN