Provider Demographics
NPI:1558442806
Name:FRIED, HOWARD STEVEN (OD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:STEVEN
Last Name:FRIED
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 1:5 OLD SCHOOLHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-2183
Mailing Address - Country:US
Mailing Address - Phone:917-913-5731
Mailing Address - Fax:516-621-5456
Practice Address - Street 1:151 W 34TH ST
Practice Address - Street 2:MACY'S VISION EXPRESS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2101
Practice Address - Country:US
Practice Address - Phone:212-494-7300
Practice Address - Fax:212-494-1123
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT005749-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01708561Medicaid