Provider Demographics
NPI:1487670816
Name:ALAN FRIEDMAN MD REHABILITATION MEDICINE INC
Entity Type:Organization
Organization Name:ALAN FRIEDMAN MD REHABILITATION MEDICINE INC
Other - Org Name:AFRM
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-447-1066
Mailing Address - Street 1:1496 CEDAR ROW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:680 BROADWAY
Practice Address - Street 2:BARNERT HOSPITAL - REHABILITATION DEPT
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1422
Practice Address - Country:US
Practice Address - Phone:908-447-1066
Practice Address - Fax:928-752-6612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA64221208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8045402Medicaid
G90306Medicare UPIN
NJ8045402Medicaid