Provider Demographics
NPI:1164494837
Name:DOWNS, FREDERICK R (MD)
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:R
Last Name:DOWNS
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:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:NORTH JAVA
Mailing Address - State:NY
Mailing Address - Zip Code:14113
Mailing Address - Country:US
Mailing Address - Phone:585-535-0051
Mailing Address - Fax:585-535-0052
Practice Address - Street 1:4174 ROUTE 98
Practice Address - Street 2:
Practice Address - City:NORTH JAVA
Practice Address - State:NY
Practice Address - Zip Code:14113
Practice Address - Country:US
Practice Address - Phone:585-535-0051
Practice Address - Fax:585-535-0052
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109864208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
000504541003OtherCOMMUNITY BLUE
00020142301OtherUNIVERA
NY00462280Medicaid
NY00462280Medicaid
00020142301OtherUNIVERA