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General NPI Number Information
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NPI Number | 1407166457
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Entity Type | Individual
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Provider Name | SANDRA A FRYREAR LCSWR
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Gender | Female
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 315 S HIGHLAND AVE
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City | BRIARCLIFF MANOR
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State | NY
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Zip | 10510-2031
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Country | US
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Telephone | 914-923-5700
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Fax | 914-923-5790
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Provider Business Mailing Address
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Address Line | 17 BROOKVIEW LN
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City | GARRISON
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State | NY
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Zip | 10524-7432
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Country | US
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Telephone | 914-923-5700
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Fax | 914-923-5790
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 072858
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License Number State | NY
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