Provider Demographics
NPI:1083818454
Name:FRECSKA, EDE (MD)
Entity Type:Individual
Prefix:DR
First Name:EDE
Middle Name:
Last Name:FRECSKA
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:KERTESZ U. 31.
Mailing Address - Street 2:FSZ. 1.
Mailing Address - City:BUDAPEST
Mailing Address - State:VII
Mailing Address - Zip Code:1073
Mailing Address - Country:HU
Mailing Address - Phone:011361-321-9328
Mailing Address - Fax:011361-200-2530
Practice Address - Street 1:79 MIDDLEVILLE RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2200
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME805022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry