Provider Demographics
NPI:1689146417
Name:LINDBERG, FREDERIK PETER (MD)
Entity Type:Individual
Prefix:
First Name:FREDERIK
Middle Name:PETER
Last Name:LINDBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 GARFIELD PL APT 2E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1963
Mailing Address - Country:US
Mailing Address - Phone:347-693-7770
Mailing Address - Fax:
Practice Address - Street 1:30 GARFIELD PL APT 2E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-1963
Practice Address - Country:US
Practice Address - Phone:347-693-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101514207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine