Individual provider Active NPI

Kristen L Fry, O.D.

  • Optometrist
  • Teaneck, NJ
National Provider Identifier
1497929707
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27TO00107500 Issued in NJ
Practice address
300 Frank W Burr Blvd
Suite 71
Teaneck, NJ 07666-6704
Phone
(201) 883-0505
Fax
(201) 692-9646
NPI assigned
Apr 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27TO00107500 NJ Primary

Addresses

Primary practice location

300 Frank W Burr Blvd
Suite 71
Teaneck, NJ 07666-6704

Mailing address

300 Frank W Burr Blvd
Suite 71
Teaneck, NJ 07666-6704
Phone (201) 883-0505

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

State licenses

LicenseStateTypeSpecialty
27TO00107500NJMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1497929707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FRANK W BURR BLVD",
            "address_2": "SUITE 71",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076666704",
            "telephone_number": "201-883-0505",
            "fax_number": "201-692-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FRANK W BURR BLVD",
            "address_2": "SUITE 71",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076666704",
            "telephone_number": "201-883-0505",
            "fax_number": "201-692-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "KRISTEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27TO00107500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.