Provider Demographics
NPI:1427201805
Name:CADET, FRESNER
Entity Type:Individual
Prefix:MR
First Name:FRESNER
Middle Name:
Last Name:CADET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85-47 66 ROAD
Mailing Address - Street 2:
Mailing Address - City:REGAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:917-864-5115
Mailing Address - Fax:
Practice Address - Street 1:85 -47 66 ROAD
Practice Address - Street 2:
Practice Address - City:REGAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:917-864-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288483164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse