Provider Demographics
NPI:1083714471
Name:FRYE, SUZANNE L (MD)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:L
Last Name:FRYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 EAST 35TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-684-6220
Mailing Address - Fax:212-779-3758
Practice Address - Street 1:35 EAST 35TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-684-6220
Practice Address - Fax:212-779-3758
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY149107174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0019876OtherGHI
NYNS387OtherOXFORD
NY27594POtherHIP
NY1C2298OtherHEALTHNET
NY119583OtherWELLCARE
NY0019583OtherGHI HMO
NY36D401OtherEMPIRE BCBS
NY56514OtherAETNA
NY119583OtherWELLCARE
NY1C2298OtherHEALTHNET