Provider Demographics
NPI:1922100486
Name:FRIEDMAN, FREDERICK JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:FRIEDMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICKY
Other - Middle Name:
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 LAKE RD S
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11020-1613
Mailing Address - Country:US
Mailing Address - Phone:516-829-0136
Mailing Address - Fax:516-829-5719
Practice Address - Street 1:47 E 88TH ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1152
Practice Address - Country:US
Practice Address - Phone:212-534-0200
Practice Address - Fax:212-534-2648
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169304207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
29F791Medicare ID - Type Unspecified
E17313Medicare UPIN