Provider Demographics
NPI:1407373772
Name:PETIT-FRERE, FRITZ DAVID (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:FRITZ
Middle Name:DAVID
Last Name:PETIT-FRERE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2302
Mailing Address - Country:US
Mailing Address - Phone:917-319-6795
Mailing Address - Fax:
Practice Address - Street 1:137 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2677
Practice Address - Country:US
Practice Address - Phone:516-833-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-27
Last Update Date:2017-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041937225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist