Provider Demographics
NPI:1518044031
Name:FRITZ, MELVIN M (DO, MD)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:M
Last Name:FRITZ
Suffix:
Gender:M
Credentials:DO, MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3 HEIKO COURT
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-3524
Mailing Address - Country:US
Mailing Address - Phone:631-912-9129
Mailing Address - Fax:631-912-9099
Practice Address - Street 1:3 HEIKO COURT
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-3524
Practice Address - Country:US
Practice Address - Phone:631-912-9129
Practice Address - Fax:631-912-9099
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY086777207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine