Provider Demographics
NPI:1184879462
Name:FRIEDMAN, EDWIN STEVEN (MA OTR/L)
Entity type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:STEVEN
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MA OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14150 71ST RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1945
Mailing Address - Country:US
Mailing Address - Phone:917-804-5775
Mailing Address - Fax:718-725-7055
Practice Address - Street 1:14150 71ST RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1945
Practice Address - Country:US
Practice Address - Phone:917-804-5775
Practice Address - Fax:718-725-7055
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-30
Last Update Date:2008-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013459225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist