Basic Information
| Provider Information | |||||||||
| NPI: | 1003009564 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEUTSCH | ||||||||
| FirstName: | FREDERICK | ||||||||
| MiddleName: | ALBERT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | CONTRA' CORNOLEO 11 | ||||||||
| Address2: | |||||||||
| City: | VICENZA | ||||||||
| State: | VICENZA | ||||||||
| PostalCode: | 36100 | ||||||||
| CountryCode: | IT | ||||||||
| TelephoneNumber: | 3484949493 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | STUDIO MEDICO VIALE SAN LAZZARO 102 | ||||||||
| Address2: | |||||||||
| City: | VICENZA | ||||||||
| State: | VICENZA | ||||||||
| PostalCode: | 36100 | ||||||||
| CountryCode: | IT | ||||||||
| TelephoneNumber: | 3484949493 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2007 | ||||||||
| LastUpdateDate: | 08/19/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171W00000X | 095429-1 | NY | Y | Other Service Providers | Contractor |
No ID Information.