Individual provider Active NPI

Coletta Lynne Fry, PHARM.D.

  • Pharmacist
  • Rochester, NY
National Provider Identifier
1700294527
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
059405 Issued in NY
Practice address
2613 W Henrietta Rd
Rochester, NY 14623-2327
Phone
(585) 279-4950
Fax
(585) 461-3942
NPI assigned
Jul 24, 2014
Last updated
Jul 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 059405 NY Primary

Addresses

Primary practice location

2613 W Henrietta Rd
Rochester, NY 14623-2327

Mailing address

2613 W Henrietta Rd
Rochester, NY 14623-2327
Phone (585) 279-4950

Other identifiers 1

IdentifierTypeStateIssuer
059405OtherNYLICENSE

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
059405NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1700294527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2613 W HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232327",
            "telephone_number": "585-279-4950",
            "fax_number": "585-461-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2613 W HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146232327",
            "telephone_number": "585-279-4950",
            "fax_number": "585-461-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "COLETTA",
        "middle_name": "LYNNE",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-24",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "059405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "059405",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.