Provider Demographics
NPI:1447605159
Name:FRYER, ANDREW ALLEN
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:ALLEN
Last Name:FRYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8533
Mailing Address - Country:US
Mailing Address - Phone:609-304-1957
Mailing Address - Fax:
Practice Address - Street 1:32 NOTTINGHAM DR
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8533
Practice Address - Country:US
Practice Address - Phone:609-304-1957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-01
Last Update Date:2016-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program