Provider Demographics
NPI:1982953618
Name:FRY, DOROTHY J (NBC-HIS, ACA)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:J
Last Name:FRY
Suffix:
Gender:F
Credentials:NBC-HIS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 W FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5017
Mailing Address - Country:US
Mailing Address - Phone:908-370-4413
Mailing Address - Fax:888-831-2486
Practice Address - Street 1:495 WATCHUNG AVE
Practice Address - Street 2:
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-4945
Practice Address - Country:US
Practice Address - Phone:908-561-1247
Practice Address - Fax:732-855-7478
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00086500237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist