Provider Demographics
NPI:1255612495
Name:EDWARD FRYMAN DPM PLLC
Entity type:Organization
Organization Name:EDWARD FRYMAN DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLLC
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-221-5982
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN2848213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP6004015103Medicaid
NYP31191Medicare PIN
NYT50882Medicare UPIN