Provider Demographics
NPI:1679668891
Name:PEKER FRIEDMANN, KATHERINA (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINA
Middle Name:
Last Name:PEKER FRIEDMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:PEKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 297 196
Mailing Address - Street 2:1610 EAST 19TH STREET
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229
Mailing Address - Country:US
Mailing Address - Phone:718-339-0041
Mailing Address - Fax:718-339-0041
Practice Address - Street 1:1745 EAST 12TH STREET
Practice Address - Street 2:#2A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-339-0041
Practice Address - Fax:718-339-0041
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144660208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01405090Medicaid
NY01405090Medicaid