Active NPI
Richard Harris Flyer, M.D.
- Pediatrics Physician
- Verona, NJ
National Provider Identifier
1104892546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA03715500
- Practice address
- 36 Park Ave
Verona, NJ 07044-2440 - Phone
- (973) 239-7001
- Fax
- (973) 239-8867
- NPI assigned
- Feb 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA03715500 | NJ | Primary |
Addresses
Primary practice location
36 Park Ave
Verona, NJ 07044-2440
Mailing address
36 Park Ave
Verona, NJ 07044-2440
Phone (973) 239-7001
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25MA03715500 | Other | NJ | STATE LICENSE PHYSICIAN |
| D02876200 | Other | NJ | CDS REGISTRATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA03715500 | NJ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1104892546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 PARK AVE",
"city": "VERONA",
"state": "NJ",
"postal_code": "070442440",
"telephone_number": "973-239-7001",
"fax_number": "973-239-8867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 PARK AVE",
"city": "VERONA",
"state": "NJ",
"postal_code": "070442440",
"telephone_number": "973-239-7001",
"fax_number": "973-239-8867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYER",
"first_name": "RICHARD",
"middle_name": "HARRIS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-26",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA03715500",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE PHYSICIAN",
"identifier": "25MA03715500",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDS REGISTRATION",
"identifier": "D02876200",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Verona, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.