Healthcare Provider Details

I. General information

NPI: 1780647271
Provider Name (Legal Business Name): JOYCE B FRIED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35104 EUCLID AVENUE #102
WILLOUGHBY OH
44094-4565
US

IV. Provider business mailing address

35104 EUCLID AVE #102
WILLOUGHBY OH
44094-4565
US

V. Phone/Fax

Practice location:
  • Phone: 440-946-0260
  • Fax: 440-946-4010
Mailing address:
  • Phone: 440-946-0260
  • Fax: 440-946-4010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number7655
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA0720
License Number StateOH

VIII. Authorized Official

Name: JOYCE B FRIED
Title or Position: OWNER MANAGER
Credential:
Phone: 440-946-0260