Active NPI
Glenn Martin Fryer
- Hearing Instrument Specialist
- Avon, CT
National Provider Identifier
1609392448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 000367
- Practice address
- 47 W Main St
Avon, CT 06001-4706 - Phone
- (860) 674-8558
- Fax
- (860) 674-1265
- NPI assigned
- Aug 14, 2017
- 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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 000367 | CT | Primary |
Addresses
Primary practice location
47 W Main St
Avon, CT 06001-4706
Mailing address
47 W Main St
Avon, CT 06001-4706
Phone (860) 674-8558
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000367 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1609392448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 W MAIN ST",
"city": "AVON",
"state": "CT",
"postal_code": "060014706",
"telephone_number": "860-674-8558",
"fax_number": "860-674-1265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47 W MAIN ST",
"city": "AVON",
"state": "CT",
"postal_code": "060014706",
"telephone_number": "860-674-8558",
"fax_number": "860-674-1265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRYER",
"first_name": "GLENN",
"middle_name": "MARTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "CT",
"license": "000367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.