Provider Demographics
NPI:1518985670
Name:FRIEDLANDER, DANIEL (M D)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:FRIEDLANDER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5400
Mailing Address - Country:US
Mailing Address - Phone:617-667-2138
Mailing Address - Fax:617-667-1171
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:S
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-2138
Practice Address - Fax:617-667-1171
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35880207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2011182Medicaid
MAB72957Medicare UPIN
MA2011182Medicaid