Provider Information for 1760604227
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Ms. PATRICIA DESIREE FRASER LCSW
Sex: Female
NPI: 1760604227
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
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NPI | 1760604227 | ||||||||
Enumeration Date | 2007-05-03 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 1154 E 99TH ST BROOKLYN, NY 11236-4424 United States Phone: 718-968-4899 | Fax: | ||||||||
Primary Practice Address | 64 E MERRICK RD VALLEY STREAM, NY 11580-5955 United States Phone: 347-528-7998 | Fax: | ||||||||
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