Provider Demographics
NPI:1174362032
Name:FRED HOLTZ
Entity type:Organization
Organization Name:FRED HOLTZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SWINARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-888-4357
Mailing Address - Street 1:535 S OYSTER BAY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3310
Mailing Address - Country:US
Mailing Address - Phone:516-888-4357
Mailing Address - Fax:516-513-1456
Practice Address - Street 1:535 S OYSTER BAY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-3310
Practice Address - Country:US
Practice Address - Phone:516-888-4357
Practice Address - Fax:516-513-1456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-21
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health