Provider Demographics
NPI:1689936221
Name:FRIEDMAN-LAST, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:FRIEDMAN-LAST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-1504
Mailing Address - Country:US
Mailing Address - Phone:516-884-5390
Mailing Address - Fax:
Practice Address - Street 1:1691 BAY BLVD
Practice Address - Street 2:
Practice Address - City:ATLANTIC BEACH
Practice Address - State:NY
Practice Address - Zip Code:11509-1504
Practice Address - Country:US
Practice Address - Phone:516-884-5390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist