Provider Demographics
NPI:1508852534
Name:FRIEDMAN, PHILIP E (OD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:E
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-1944
Mailing Address - Country:US
Mailing Address - Phone:781-272-9365
Mailing Address - Fax:781-272-0366
Practice Address - Street 1:385 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-1944
Practice Address - Country:US
Practice Address - Phone:781-272-9365
Practice Address - Fax:781-272-0366
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2094152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0305715Medicaid
MA0305715Medicaid
MA94174Medicare UPIN