Provider Demographics
NPI:1275934200
Name:FRIEDMAN, PAUL LAWRENCE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:LAWRENCE
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-4654
Mailing Address - Country:US
Mailing Address - Phone:609-971-3500
Mailing Address - Fax:609-971-3545
Practice Address - Street 1:13 W ORMOND AVE
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3041
Practice Address - Country:US
Practice Address - Phone:856-533-5395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC007202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor