Walter F Fricke, D.AC, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25MZ00038000 Issued in NJ

Practice address

125 Prospect St
South Orange, NJ 07079-1801

Phone

(201) 654-7415

NPI assigned

Oct 27, 2007

Last updated

Sep 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

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  • NPI 1558406686

  Acupuncturist

  NPD (past)

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

{
    "created_epoch": "1193443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599868800000",
    "number": "1992984819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ROOSEVELT PL APT 4S",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423374",
            "telephone_number": "201-654-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PROSPECT ST",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791801",
            "telephone_number": "201-654-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICKE",
        "first_name": "WALTER",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.AC, L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-27",
        "last_updated": "2020-09-12",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "RI",
            "license": "DA00313",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00038000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baijnatha Florestal, RBT
• Pamela F Foley, PHD
• Kemoy Fong
• Duane Fredericks, M.D.
• Tracy Margaret Fredericks, LCSW, MSW
• Khadijah Friday
• Blaire Erica Fuchs, LCSW
• Cynthia A Galeota, CNM
• Champaklal K Gandhi, M.D.
• Kinnari C Gandhi

• Acupuncturist in South Orange, NJ
• Providers in South Orange, NJ by specialty
• Acupuncturist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2020; 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.