Healthcare Provider Details

I. General information

NPI: 1720224637
Provider Name (Legal Business Name): ERIN ANN FRYE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2008
Last Update Date: 05/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE
NEW YORK NY
10065-5992
US

IV. Provider business mailing address

1470 ANNUNCIATION ST APT 3217
NEW ORLEANS LA
70130-8616
US

V. Phone/Fax

Practice location:
  • Phone: 212-217-4190
  • Fax:
Mailing address:
  • Phone: 608-215-0528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number305011
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number335818
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number129331-6101
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: