Provider Demographics
NPI:1225057649
Name:FREY, DAVID K (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:K
Last Name:FREY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:301 PROSPECT AVE
Mailing Address - Street 2:CPEP
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1807
Mailing Address - Country:US
Mailing Address - Phone:315-726-8610
Mailing Address - Fax:315-726-8671
Practice Address - Street 1:301 PROSPECT AVE
Practice Address - Street 2:CPEP
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1807
Practice Address - Country:US
Practice Address - Phone:315-726-8610
Practice Address - Fax:315-726-8671
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-04-12
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Provider Licenses
StateLicense IDTaxonomies
NY207253-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DD6691Medicare PIN
NYH91562Medicare UPIN