Provider Demographics
NPI:1760419659
Name:FRIEDMAN, TERRY D (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:D
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 ROUTE 70 E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2230
Mailing Address - Country:US
Mailing Address - Phone:856-216-0300
Mailing Address - Fax:856-216-7142
Practice Address - Street 1:1400 ROUTE 70 E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2230
Practice Address - Country:US
Practice Address - Phone:856-216-0300
Practice Address - Fax:856-216-7142
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020895E207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016885800001Medicaid
C54078Medicare UPIN
PA003787Medicare PIN