Provider Demographics
NPI:1275693475
Name:FRIEDMAN, ROBERT (PHYSICALTHERAPIST)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:PHYSICALTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 GORDONS CORNER RD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3356
Mailing Address - Country:US
Mailing Address - Phone:732-446-1400
Mailing Address - Fax:732-446-1403
Practice Address - Street 1:225 GORDONS CORNER RD
Practice Address - Street 2:SUITE 2B
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3356
Practice Address - Country:US
Practice Address - Phone:732-446-1400
Practice Address - Fax:732-446-1403
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00191300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6189620001Medicare NSC