Provider Demographics
NPI:1952453722
Name:NEUSCHOTZ, FRIEDA (MD)
Entity Type:Individual
Prefix:DR
First Name:FRIEDA
Middle Name:
Last Name:NEUSCHOTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:99 JERICHO TPKE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1073
Mailing Address - Country:US
Mailing Address - Phone:516-338-2900
Mailing Address - Fax:516-338-2902
Practice Address - Street 1:99 JERICHO TPKE
Practice Address - Street 2:SUITE 206
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1073
Practice Address - Country:US
Practice Address - Phone:516-338-2900
Practice Address - Fax:516-338-2902
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY170954208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA62523Medicare UPIN