Provider Demographics
NPI:1659370245
Name:FRYMAN, EDWARD (DPM)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:FRYMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2811
Mailing Address - Country:US
Mailing Address - Phone:516-221-5982
Mailing Address - Fax:516-221-0729
Practice Address - Street 1:3650 MERRICK RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2811
Practice Address - Country:US
Practice Address - Phone:516-221-5982
Practice Address - Fax:516-221-0729
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT50882213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP6 004015103Medicaid
NYT50882Medicare UPIN
NYP6 004015103Medicaid