Provider Demographics
NPI:1134453947
Name:FRIEND, JOEL PRESTON
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:PRESTON
Last Name:FRIEND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 LENOX AVE
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-4315
Mailing Address - Country:US
Mailing Address - Phone:724-989-8232
Mailing Address - Fax:
Practice Address - Street 1:13 LENOX AVE
Practice Address - Street 2:APT. # 1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-4315
Practice Address - Country:US
Practice Address - Phone:724-989-8232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA27683968252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency