Provider Demographics
NPI:1720300668
Name:GERALD J. FRIEDMAN DIABETES INSTITUTE
Entity Type:Organization
Organization Name:GERALD J. FRIEDMAN DIABETES INSTITUTE
Other - Org Name:FRIEDMAN DIABETES INSTITLUTE (FDI)
Other - Org Type:Other Name
Authorized Official - Title/Position:CERTIFIED DIABETES EDUCATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEJESUS
Authorized Official - Suffix:
Authorized Official - Credentials:CDE
Authorized Official - Phone:212-420-3446
Mailing Address - Street 1:317 E 17TH ST
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3804
Mailing Address - Country:US
Mailing Address - Phone:212-420-3446
Mailing Address - Fax:212-420-2224
Practice Address - Street 1:317 E 17TH ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3804
Practice Address - Country:US
Practice Address - Phone:212-420-3446
Practice Address - Fax:212-420-2224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BETH ISRAEL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2071-0075174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty