Provider Demographics
NPI:1376872374
Name:CARL B FRIEDMAN MDPC
Entity type:Organization
Organization Name:CARL B FRIEDMAN MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:BERTRAM
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-374-1818
Mailing Address - Street 1:123 MAPLE AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2240
Mailing Address - Country:US
Mailing Address - Phone:516-374-1818
Mailing Address - Fax:516-374-1830
Practice Address - Street 1:123 MAPLE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2240
Practice Address - Country:US
Practice Address - Phone:516-374-1818
Practice Address - Fax:516-374-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB77871Medicare UPIN