Provider Demographics
NPI:1376543231
Name:FRIEDLAND, RICHARD J (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:FRIEDLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2678 SOUTH RD STE 202
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5254
Mailing Address - Country:US
Mailing Address - Phone:845-790-5700
Mailing Address - Fax:845-790-5719
Practice Address - Street 1:45 READE PL
Practice Address - Street 2:VASSAR BROTHERS MEDICAL CENTER
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3947
Practice Address - Country:US
Practice Address - Phone:845-454-4700
Practice Address - Fax:845-454-4982
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1857282085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01541928Medicaid
NY62U561Medicare ID - Type Unspecified
NYF55774Medicare UPIN