Basic Information
| Provider Information | |||||||||
| NPI: | 1932361466 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FRIDMAN MEDICAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6740 YELLOWSTONE BLVD | ||||||||
| Address2: | |||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113752668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182752224 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6260 108TH ST | ||||||||
| Address2: | |||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113751356 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182752224 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2008 | ||||||||
| LastUpdateDate: | 06/26/2008 | ||||||||
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| AuthorizedOfficialLastName: | FRIDMAN | ||||||||
| AuthorizedOfficialFirstName: | MOISEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7182752224 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 228200 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.