Provider Demographics
NPI:1063452514
Name:FRIED, ARNO H (MD,FACS)
Entity Type:Individual
Prefix:DR
First Name:ARNO
Middle Name:H
Last Name:FRIED
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ROUTE 17 NORTH
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070
Mailing Address - Country:US
Mailing Address - Phone:201-457-0044
Mailing Address - Fax:201-457-0049
Practice Address - Street 1:201 ROUTE 17 NORTH
Practice Address - Street 2:5TH FLOOR
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070
Practice Address - Country:US
Practice Address - Phone:201-457-0044
Practice Address - Fax:201-457-0049
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06554700174400000X
NJ1466681207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ010760DHKMedicare ID - Type Unspecified
NJC32752Medicare UPIN