Provider Demographics
NPI:1568432771
Name:FREY, RICHARD G (PHD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
Last Name:FREY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 DRIFTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2515
Mailing Address - Country:US
Mailing Address - Phone:412-828-7611
Mailing Address - Fax:
Practice Address - Street 1:100 NORTHPOINTE CIR
Practice Address - Street 2:SUITE 306
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7851
Practice Address - Country:US
Practice Address - Phone:724-772-4848
Practice Address - Fax:724-772-4888
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005779L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA628747Medicare ID - Type Unspecified