Provider Demographics
NPI:1730142035
Name:FRIEDLANDER, PATSY A (OTR)
Entity Type:Individual
Prefix:
First Name:PATSY
Middle Name:A
Last Name:FRIEDLANDER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W FRONT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2236
Mailing Address - Country:US
Mailing Address - Phone:231-995-9748
Mailing Address - Fax:231-995-9745
Practice Address - Street 1:701 W FRONT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2236
Practice Address - Country:US
Practice Address - Phone:231-995-9748
Practice Address - Fax:231-995-9745
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001402225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
5654790001Medicare NSC
N13430003Medicare PIN