Provider Demographics
NPI:1235705849
Name:FROEHLICH, CYDNEY CAYE (OD)
Entity Type:Individual
Prefix:
First Name:CYDNEY
Middle Name:CAYE
Last Name:FROEHLICH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 E UNION HILLS DR APT 3037
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3371
Mailing Address - Country:US
Mailing Address - Phone:952-356-6861
Mailing Address - Fax:
Practice Address - Street 1:21001 N TATUM BLVD STE 20
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-4207
Practice Address - Country:US
Practice Address - Phone:480-419-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-03
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3726152W00000X
AZOPT-002518152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist