Provider Demographics
NPI:1245277003
Name:FRIEDLAND, BERNARD M (OD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:M
Last Name:FRIEDLAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900B CUNNINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-4260
Mailing Address - Country:US
Mailing Address - Phone:757-825-1804
Mailing Address - Fax:757-825-5484
Practice Address - Street 1:1900B CUNNINGHAM DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-4260
Practice Address - Country:US
Practice Address - Phone:757-825-1804
Practice Address - Fax:757-825-5484
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0601000464152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009230793Medicaid
VA410001227Medicare ID - Type Unspecified
VAT-21736Medicare UPIN