Basic Information
| Provider Information | |||||||||
| NPI: | 1750556270 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FRIDMANS MEDICAL PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6740 YELLOWSTONE BLVD | ||||||||
| Address2: | 4E | ||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113752668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3476101186 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9732 63RD RD | ||||||||
| Address2: | |||||||||
| City: | REGO PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113741639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182752224 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2008 | ||||||||
| LastUpdateDate: | 06/13/2016 | ||||||||
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| AuthorizedOfficialLastName: | ASHEROVA | ||||||||
| AuthorizedOfficialFirstName: | ANELINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7182752224 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NW0100X | 228200 | NY | N | Hospitals | General Acute Care Hospital | Women | 174400000X | 228200 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.