Provider Demographics
NPI:1629275219
Name:FRIEDMAN, JEREMY ZVI (CNIM, DC)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:ZVI
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:CNIM, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N VILLAGE AVE
Mailing Address - Street 2:#B7
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2341
Mailing Address - Country:US
Mailing Address - Phone:973-986-2763
Mailing Address - Fax:
Practice Address - Street 1:200 N VILLAGE AVE
Practice Address - Street 2:#B7
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2341
Practice Address - Country:US
Practice Address - Phone:973-986-2763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10670111N00000X
NY1828246ZE0600X
NYX011484-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No111N00000XChiropractic ProvidersChiropractor