Provider Demographics
NPI:1427480052
Name:FREY, ROBERT KEVIN (DC LLC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KEVIN
Last Name:FREY
Suffix:
Gender:M
Credentials:DC LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 EAST 42ND ST.
Mailing Address - Street 2:SUITE #808
Mailing Address - City:N.Y.
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:212-687-0600
Mailing Address - Fax:212-687-0022
Practice Address - Street 1:51 EAST 42ND ST.
Practice Address - Street 2:SUITE #808
Practice Address - City:N.Y.
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-687-0600
Practice Address - Fax:212-687-0022
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004631-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor