Provider Demographics
NPI:1235891029
Name:FRIDKIS, GILA (MGC, CGC)
Entity Type:Individual
Prefix:
First Name:GILA
Middle Name:
Last Name:FRIDKIS
Suffix:
Gender:F
Credentials:MGC, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 READE PL STE 1000
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3950
Mailing Address - Country:US
Mailing Address - Phone:845-214-1821
Mailing Address - Fax:845-214-1835
Practice Address - Street 1:21 READE PL STE 1000
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3950
Practice Address - Country:US
Practice Address - Phone:845-214-1821
Practice Address - Fax:845-214-1835
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS