Provider Demographics
NPI:1720108806
Name:FRIEDMAN, ALISA P (OD)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:P
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-1140
Mailing Address - Country:US
Mailing Address - Phone:585-256-2603
Mailing Address - Fax:
Practice Address - Street 1:154 GREECE RIDGE CENTER DR
Practice Address - Street 2:THE MALL AT GREECE-RIDGE CENTER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-2815
Practice Address - Country:US
Practice Address - Phone:716-227-8580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006747-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist