Inna Fredericks

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

167 Clermont Ave
Brooklyn, NY 11205-3303

Phone

(718) 854-3710

NPI assigned

Jun 10, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Child Study Center of New York

  • Early Intervention Provider Agency
  • Brooklyn, NY
  • NPI 1861793788
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1477283786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 CLERMONT AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112053303",
            "telephone_number": "718-854-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 CLERMONT AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112053303",
            "telephone_number": "718-854-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "INNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ifredericks@cscofny.org",
            "affiliation": "Y",
            "affiliationName": "THE CHILD STUDY CENTER OF NEW YORK",
            "address_1": "167 Clermont Ave",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112053303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Raheeman Joy Frederick
• Renee Jwanza Frederick
• Shara Joanne Frederick, CM,LM,MS
• Arlene Lucille Fredericks, ACNP-BC
• Dale Fredericks
• Marcia Lynn Fredericks, RN
• Winnet Fredericks
• Malissa Frederique, DDS
• Anielle M Fredman, PHD
• Peter Jay Fredman, MD

• Speech-Language Pathologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.