Provider Demographics
NPI:1770607632
Name:FRIEDMAN, SUSAN C (DC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:C
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S RIDGE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-2812
Mailing Address - Country:US
Mailing Address - Phone:914-934-2000
Mailing Address - Fax:914-206-3627
Practice Address - Street 1:111 S RIDGE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2812
Practice Address - Country:US
Practice Address - Phone:914-934-2000
Practice Address - Fax:914-206-3627
Is Sole Proprietor?:No
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005525-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX29861Medicare ID - Type Unspecified