Provider Demographics
NPI:1619996998
Name:FRIEDEMAN, STEVEN D (PT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:FRIEDEMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WALTER E. FORAN BLD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822
Mailing Address - Country:US
Mailing Address - Phone:908-237-0000
Mailing Address - Fax:908-237-0001
Practice Address - Street 1:1 BETHANY RD BLDG 4
Practice Address - Street 2:SUITE 53, BETHANY COMMONS
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1667
Practice Address - Country:US
Practice Address - Phone:732-335-8111
Practice Address - Fax:732-335-8118
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00720800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA00720800OtherSTATE LICENSE NUMBER
NJ07720BC1Medicare ID - Type Unspecified