Provider Demographics
NPI:1225651383
Name:FREDANKEY-PARZYCH, KADEEJA (MD)
Entity Type:Individual
Prefix:
First Name:KADEEJA
Middle Name:
Last Name:FREDANKEY-PARZYCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 KENNEDY PKWY
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-1435
Mailing Address - Country:US
Mailing Address - Phone:607-591-4429
Mailing Address - Fax:
Practice Address - Street 1:14 KENNEDY PKWY
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-1435
Practice Address - Country:US
Practice Address - Phone:607-591-4429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-24
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319060207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine