Provider Demographics
NPI:1962453092
Name:FRIEDMAN, ELIOT L (MD)
Entity Type:Individual
Prefix:
First Name:ELIOT
Middle Name:L
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:
Practice Address - Street 1:1240 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6369
Practice Address - Country:US
Practice Address - Phone:610-402-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419766207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0418137000OtherKEYSTONE EAST
PA137794OtherTHREE RIVERS/UNISON
PA50003681OtherCAPITAL BLUE CROSS
PA77776OtherGEISINGER HEALTH PLAN
PA1528698OtherGATEWAY HEALTH PLAN
PAP3157020OtherOXFORD HEALTH PLAN
PA900004276OtherRAILROAD MEDICARE
PA0418137000OtherAMERIHEALTH (IBC)
PA062952Medicare ID - Type Unspecified
PA1915517Medicaid
PA20019207OtherAMERIHEALTH MERCY
PAA64724Medicare UPIN
PA961865OtherKEYSTONE CENTRAL
PA961865OtherHIGHMARK BLUESHIELD