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Individual
MR. KENNETH IRA FREY
Active
Individual
MR. KENNETH IRA FREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006373
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N46394
ORTHONET
NY
01
—
Q5669
EMPIRE BLUE CROSS/BLUE SH
NY
Enumeration date
04/10/2008
Last updated
04/10/2008
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