Provider Demographics
NPI:1275001315
Name:FRIEDMAN, MARC (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MONTGOMERY AVE APT B2
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2926
Mailing Address - Country:US
Mailing Address - Phone:215-595-7782
Mailing Address - Fax:
Practice Address - Street 1:1740 SOUTH ST STE 501
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1572
Practice Address - Country:US
Practice Address - Phone:215-962-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453009183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist