Provider Demographics
NPI:1821175530
Name:FRIEDMAN, RENAY M (DC)
Entity Type:Individual
Prefix:DR
First Name:RENAY
Middle Name:M
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 SCENIC DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5210
Mailing Address - Country:US
Mailing Address - Phone:732-863-7400
Mailing Address - Fax:732-863-7497
Practice Address - Street 1:1001 US HIGHWAY 9
Practice Address - Street 2:STE 101
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3301
Practice Address - Country:US
Practice Address - Phone:732-863-7400
Practice Address - Fax:732-863-7497
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04728111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6671209Medicaid
NJ6671209Medicaid
NJ822106Medicare ID - Type Unspecified