Provider Demographics
NPI:1700042900
Name:FRIEDMAN, JOANNE CANTOR (APRN, ANP, WHCNP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:CANTOR
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:APRN, ANP, WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 WASHINGTON ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2700
Mailing Address - Country:US
Mailing Address - Phone:860-886-1956
Mailing Address - Fax:860-887-2048
Practice Address - Street 1:330 WASHINGTON ST
Practice Address - Street 2:SUITE 350
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2700
Practice Address - Country:US
Practice Address - Phone:860-886-1956
Practice Address - Fax:860-887-2048
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001433363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT500000073Medicare PIN