Most Relevant Information
Provider Data
| NPI Number: | 1003634510 |
| Provider Name: | PRUDENCE FRYE |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 262981 |
Most Important Dates
| Enumeration Date: | 10/02/2024 |
| Last Updated: | 10/02/2024 |
Provider Practice Location
73A TROY RD
EAST GREENBUSH
NY
120611310
Practice Location Phone/Fax
| Phone: | 5184491142 |
| Fax: |
Provider Mailing Location
PO BOX 148
RENSSELAER
NY
121440148
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |