Provider Demographics
NPI:1750556270
Name:FRIDMANS MEDICAL PLLC
Entity type:Organization
Organization Name:FRIDMANS MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHEROVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-275-2224
Mailing Address - Street 1:6740 YELLOWSTONE BLVD
Mailing Address - Street 2:4E
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2668
Mailing Address - Country:US
Mailing Address - Phone:347-610-1186
Mailing Address - Fax:
Practice Address - Street 1:9732 63RD RD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1639
Practice Address - Country:US
Practice Address - Phone:718-275-2224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228200174400000X, 282NW0100X
207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No282NW0100XHospitalsGeneral Acute Care HospitalWomenGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06893Medicare PIN
NYI01159Medicare UPIN