Provider Demographics
NPI:1952478539
Name:FRIEDMAN, LYNN CARLA (DC)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:CARLA
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 1:978 ROUTE 45 STE 109A
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3565
Mailing Address - Country:US
Mailing Address - Phone:845-786-2022
Mailing Address - Fax:845-786-2098
Practice Address - Street 1:978 ROUTE 45 STE 109A
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3565
Practice Address - Country:US
Practice Address - Phone:845-786-2022
Practice Address - Fax:845-786-2098
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0058181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
N34176OtherMULTIPLAN
0071231OtherGHI
NY01910205Medicaid
2004030OtherUS HEALTH CARE
NYP513612OtherOXFORD
C058182OtherWORKERS COMP
NY4564188OtherAETNA
2004030OtherUS HEALTH CARE
U06484Medicare UPIN
V06484Medicare UPIN