Provider Demographics
NPI:1871222315
Name:FRIEDMAN, MADISON LANE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:MADISON
Middle Name:LANE
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 RIGENE RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-1223
Mailing Address - Country:US
Mailing Address - Phone:914-216-1494
Mailing Address - Fax:
Practice Address - Street 1:40 RIGENE RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1223
Practice Address - Country:US
Practice Address - Phone:914-216-1494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant