Aimee Fredette

Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Tupper Lake, NY

NPI 1659978583 · NPPES record last updated Oct 5, 2020

Key facts

NPI
1659978583
Entity type
Individual (NPI type 1)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
License
046423 (NY)
Practice address
55 Church St
Tupper Lake, NY 12986-2032
Phone
(518) 359-2479
Fax
(518) 359-8364
NPI assigned
Oct 5, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
046423NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
High Peaks Radiology PC Past
since Oct 11, 2020
Accepting new patients
Adirondack Medical Center Past
since Oct 11, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 046423 NY Yes

Addresses

Primary practice location

55 Church St
Tupper Lake, NY 12986-2032

Mailing address

2233 State Route 86
Saranac Lake, NY 12983-5644
Phone (518) 891-4141

Other practice location 1

55 Church St
Tupper Lake, NY 12986-2032
Phone (518) 359-2479

Other providers in Tupper Lake, NY

All providers in Tupper Lake, NY · Physical Medicine & Rehabilitation Physician in New York

Sources for this page

Verify at the official NPI Registry.