Provider Demographics
NPI:1760721401
Name:BRUCE FRIEDLANDER DPM PC
Entity Type:Organization
Organization Name:BRUCE FRIEDLANDER DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:FRIEDLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-840-0220
Mailing Address - Street 1:567 9TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4205
Mailing Address - Country:US
Mailing Address - Phone:718-840-0220
Mailing Address - Fax:718-965-2371
Practice Address - Street 1:567 9TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4205
Practice Address - Country:US
Practice Address - Phone:718-840-0220
Practice Address - Fax:718-965-2371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3238213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT51021Medicare UPIN