Provider Demographics
NPI:1821006636
Name:FRYER, ROBERT HUGH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HUGH
Last Name:FRYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 W 168TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3726
Mailing Address - Country:US
Mailing Address - Phone:646-426-3876
Mailing Address - Fax:212-326-8530
Practice Address - Street 1:180 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3722
Practice Address - Country:US
Practice Address - Phone:646-426-3876
Practice Address - Fax:212-326-8530
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2232252084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02424775Medicaid
NY440N21Medicare ID - Type Unspecified
NYI00157Medicare UPIN