Provider Demographics
NPI:1356363352
Name:FRIEDMAN, SAMUEL H (MD, FACC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:H
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 ESSEX ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3231
Mailing Address - Country:US
Mailing Address - Phone:201-487-2924
Mailing Address - Fax:201-487-2853
Practice Address - Street 1:211 ESSEX ST
Practice Address - Street 2:SUITE 304
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3231
Practice Address - Country:US
Practice Address - Phone:201-487-2924
Practice Address - Fax:201-487-2853
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05034600207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD84679Medicare UPIN
NJ574027Medicare ID - Type Unspecified