Provider Demographics
NPI:1396817268
Name:FIEVRE GARNES, MARIE F T FRITZA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:F T FRITZA
Last Name:FIEVRE GARNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:F
Other - Last Name:GARNES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:60 MADISON AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1600
Mailing Address - Country:US
Mailing Address - Phone:212-545-2439
Mailing Address - Fax:646-312-0481
Practice Address - Street 1:9704 SUTPHIN BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-4721
Practice Address - Country:US
Practice Address - Phone:718-657-7088
Practice Address - Fax:718-657-7092
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233833208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02618399Medicaid
NY00695941Medicaid
NYW6L111Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331946Medicare Oscar/Certification
NY331947Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY00695941Medicaid
NY331009Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY331043Medicare Oscar/Certification
NY331954Medicare Oscar/Certification