Larry Fryer (NPI# 1134203060, PAC ID# 8224227434) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1134203060 |
| PAC ID by PECOS | 8224227434 |
| Professional Enrollment ID | I20110104000557 |
| Full Name | Larry Fryer |
| Organization Legal Name | NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH-MENTAL RETARDATION I |
| Address |
Roosevelt Blvd At Adams Philadelphia PA 19124-1552 |
| Phone Number | 2158312800 |
| Gender | M |
| Medical School | UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE |
| Graduation Year | 1964 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 9931195450 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| Roosevelt Blvd At Adams, Philadelphia, PA 19124-1552 | 2158312800 | NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH-MENTAL RETARDATION I |
| Organization Legal Name | NORTHEAST COMMUNITY CENTER FOR MENTAL HEALTH-MENTAL RETARDATION I |
| Physicians | 13 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brooks Allen Aylor | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Eliza N Wilfred | Psychiatry | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd At Adams, Philadelphia, PA 19124-1552 |
| Patrick M Johnson | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| David Como | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Paula B Slomsky | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Susan Siegelman | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Patrick Kevin Grugan | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Liudmila Lobach | Psychiatry | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Lisa Vinnacombe | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Aleka Kostouros | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Street Address |
ROOSEVELT BLVD AT ADAMS |
| City | PHILADELPHIA |
| State | PA |
| Zip | 19124-1552 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eliza N Wilfred | Psychiatry | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd At Adams, Philadelphia, PA 19124-1552 |
| Ajeetha Ravindradoss | Psychiatry | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd At Adams, Philadelphia, PA 19124-1552 |
| Lourdes M Santoni | Nurse Practitioner | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd At Adams, Philadelphia, PA 19124-1552 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brooks Allen Aylor | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Patrick M Johnson | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| David Como | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Paula B Slomsky | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Susan Siegelman | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Patrick Kevin Grugan | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Liudmila Lobach | Psychiatry | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Lisa Vinnacombe | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Aleka Kostouros | Clinical Social Worker | Northeast Community Center for Mental Health-mental Retardation I | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Emma Hazanov | Clinical Social Worker | Northeast Community Center for Mental Health and Mental Retardation | Roosevelt Blvd Adams Ave, Philadelphia, PA 19124 |
| Find all physicians in zip 19124 | |||
| City | PHILADELPHIA |
| Zip Code | 19124 |
| Specialty | PSYCHIATRY |
| City + Specialty | PHILADELPHIA + PSYCHIATRY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.