Provider Demographics
NPI:1972779981
Name:FRECHTER, GARY DAVID (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:DAVID
Last Name:FRECHTER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 ARBUCKLE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2701
Mailing Address - Country:US
Mailing Address - Phone:516-295-3181
Mailing Address - Fax:516-295-5839
Practice Address - Street 1:3199 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-4107
Practice Address - Country:US
Practice Address - Phone:516-766-7200
Practice Address - Fax:516-763-1426
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY13869183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist