Provider Demographics
NPI:1851414288
Name:FREY, RICHARD K (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:K
Last Name:FREY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 W. MOORESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064
Mailing Address - Country:US
Mailing Address - Phone:610-759-1300
Mailing Address - Fax:610-759-4418
Practice Address - Street 1:11 ROCKDALE LN
Practice Address - Street 2:BUTLER PARK
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360
Practice Address - Country:US
Practice Address - Phone:570-424-6782
Practice Address - Fax:570-476-7699
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001460L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2909500OtherCAPITAL BC
NY5802644OtherGHI
PA607155OtherUNITED HEALTHCARE
PA20017664OtherAMERI HEALTH MERCY
PA179559OtherHIGHMARK
PA076225Other1ST PRIORITY
PA0010759730007Medicaid
PA1015862OtherAETNA
PA179559OtherHIGHMARK