Provider Demographics
NPI:1164543575
Name:PHILIP FRIED
Entity Type:Organization
Organization Name:PHILIP FRIED
Other - Org Name:WESTCHESTER DERMATOLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-949-6070
Mailing Address - Street 1:20 OLD MAMARONECK RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2060
Mailing Address - Country:US
Mailing Address - Phone:914-949-6070
Mailing Address - Fax:914-949-4560
Practice Address - Street 1:20 OLD MAMARONECK RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2060
Practice Address - Country:US
Practice Address - Phone:914-949-6070
Practice Address - Fax:914-949-4560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty