Provider Demographics
NPI:1629146733
Name:FRIED, STEVEN HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:HOWARD
Last Name:FRIED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 GEORGE ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2009
Mailing Address - Country:US
Mailing Address - Phone:732-846-6100
Mailing Address - Fax:732-846-6113
Practice Address - Street 1:303 GEORGE ST
Practice Address - Street 2:SUITE 105
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2009
Practice Address - Country:US
Practice Address - Phone:732-846-6100
Practice Address - Fax:732-846-6113
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ39009207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0617202Medicaid
NJP678611OtherOXFORD
NJ0617202Medicaid
NJFE191979Medicare ID - Type Unspecified