Basic Information
Provider Information
NPI: 1144238676
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRIEDENHEIM
FirstName: RICHARD
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1235 OLD YORK ROAD
Address2: STE 121
City: ABINGTON
State: PA
PostalCode: 190013840
CountryCode: US
TelephoneNumber: 2155171200
FaxNumber: 2155171219
Practice Location
Address1: 1235 OLD YORK ROAD
Address2: STE 121
City: ABINGTON
State: PA
PostalCode: 190013840
CountryCode: US
TelephoneNumber: 2155171200
FaxNumber: 2155171219
Other Information
ProviderEnumerationDate: 08/03/2006
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200XMD042408LPAN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RP1001XMD042408LPAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

ID Information
IDTypeStateIssuerDescription
001214807000805PA MEDICAID


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