Provider Demographics
NPI:1205856465
Name:FRIEDMAN, ALAN HARRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:HARRIS
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 MARTIN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314
Mailing Address - Country:US
Mailing Address - Phone:718-698-8047
Mailing Address - Fax:718-987-9610
Practice Address - Street 1:1145 TARGEE ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4323
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:718-987-9610
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189140207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF85734Medicare UPIN