Basic Information
| Provider Information | |||||||||
| NPI: | 1447589718 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRYDMAN | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 HITCHCOCK WAY | ||||||||
| Address2: | DARTMOUTH HITCHCOCK - PEDIATRICS | ||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036952500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 100 HITCHCOCK WAY | ||||||||
| Address2: | DARTMOUTH HITCHCOCK - PEDIATRICS | ||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036952500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2009 | ||||||||
| LastUpdateDate: | 08/06/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0205X | 16164 | NH | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Endocrinology | 208000000X | 16164 | NH | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 3087320 | 05 | NH | MEDICAID |