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Individual

MR. DOUGLAS E FRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
231 AVON RD, NARBERTH, PA 19072
(267) 263-0657
(267) 263-0667
Mailing address
615 W MAIN ST, LANSDALE, PA 19446-2011
(610) 940-2604
(610) 940-2605

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN247115L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7660353
PA
Enumeration date
02/28/2006
Last updated
07/19/2016
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