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NPI Code Detail

MEDICARE: DR. PAUL A. FRYMOYER M.D.

MEDICARE:  DR. PAUL A. FRYMOYER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician140841NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
6110059026OTHERNYRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000914918001OTHERNYHEALTHNOW
200040148603OTHERNYUNIVERA SENIOR CHOICE
310119424OTHERNYCDPHP
43399723OTHERNYGHI
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7950184OTHERNYMVP
84535674OTHERNYAETNA
9100024666301OTHERNYUNITED HEALTHCARE

General Provider Information

NPI Number : 1336121268
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL A. FRYMOYER M.D.
Provider Business Mailing Address
First Line : 7650 LINKSIDE DR.
Second Line :
City : MANLIUS
State : NY
Zip : 13104
Country : US
Telephone Number : 315-682-4468
Fax Number :
Provider Business Practice Location Address
First Line : 7650 LINKSIDE DR.
Second Line :
City : MANLIUS
State : NY
Zip : 13104
Country : US
Telephone Number : 315-682-4468
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 02/03/2009

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