Provider Demographics
NPI:1790783157
Name:FRIEDMAN, JEFFREY P (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
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 1:317 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4974
Mailing Address - Country:US
Mailing Address - Phone:212-726-7440
Mailing Address - Fax:212-209-3240
Practice Address - Street 1:317 E 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4974
Practice Address - Country:US
Practice Address - Phone:212-726-7440
Practice Address - Fax:212-209-3240
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158591207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01013785Medicaid
NY89D371Medicare ID - Type Unspecified
NY01013785Medicaid