Healthcare Provider Details

I. General information

NPI: 1346316635
Provider Name (Legal Business Name): CYNTHIA JAY FRISCHMANN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 06/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 N SHADELAND AVE SUITE #160
INDIANAPOLIS IN
46250-2029
US

IV. Provider business mailing address

7440 N SHADELAND AVE SUITE #160
INDIANAPOLIS IN
46250-2029
US

V. Phone/Fax

Practice location:
  • Phone: 317-915-3937
  • Fax: 317-915-3946
Mailing address:
  • Phone: 317-915-3937
  • Fax: 317-915-3946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number18002565A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: