Provider Demographics
NPI:1407192594
Name:YANKEE NEUROPHYSIOLOGY, P.C.
Entity Type:Organization
Organization Name:YANKEE NEUROPHYSIOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:484-351-8459
Mailing Address - Street 1:PO BOX 28416
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-8416
Mailing Address - Country:US
Mailing Address - Phone:484-351-8459
Mailing Address - Fax:
Practice Address - Street 1:100 FRONT STREET
Practice Address - Street 2:SUITE 280
Practice Address - City:WEST CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2891
Practice Address - Country:US
Practice Address - Phone:484-351-8459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty