Provider Demographics
NPI:1770858516
Name:FRIEDMAN, LLOYD ALAN (PT)
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:ALAN
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 STURBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1262
Mailing Address - Country:US
Mailing Address - Phone:201-825-6811
Mailing Address - Fax:
Practice Address - Street 1:310 STURBRIDGE CT
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1262
Practice Address - Country:US
Practice Address - Phone:201-825-6811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003885172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker