Provider Demographics
NPI:1518330935
Name:FRIEDENBERG, CRAIG (OD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:FRIEDENBERG
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 1:6500 RED HOOK PLZ STE 225
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-1306
Mailing Address - Country:US
Mailing Address - Phone:340-779-2019
Mailing Address - Fax:340-779-2020
Practice Address - Street 1:6500 RED HOOK PLZ STE 225
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-1306
Practice Address - Country:US
Practice Address - Phone:340-779-2019
Practice Address - Fax:340-779-2020
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-06
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIVI 9152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist