Provider Demographics
NPI:1801275243
Name:TUCKER, FREDERICK CURTIS III (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:CURTIS
Last Name:TUCKER
Suffix:III
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 1:1925 EASTCHESTER RD
Mailing Address - Street 2:APT 28G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2103
Mailing Address - Country:US
Mailing Address - Phone:347-835-9981
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PKWY S
Practice Address - Street 2:BUILDING 6//SUITE B125
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program