MEDICARE: GARY SETH FRIEDMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	15793	AL
2	2084N0400X	Neurology Physician	17079	OK
3	2084N0400X	Neurology Physician	104975	MO
4	2084N0400X	Neurology Physician	18862	WV
5	2084N0400X	Neurology Physician	144674	NY
6	208100000X	Physical Medicine & Rehabilitation Physician	144674	NY
7	208100000X	Physical Medicine & Rehabilitation Physician	15793	AL
8	208100000X	Physical Medicine & Rehabilitation Physician	17079	OK
9	208100000X	Physical Medicine & Rehabilitation Physician	104975	MO
10	208100000X	Physical Medicine & Rehabilitation Physician	18862	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0551089	OTHER	CIGNA
2	GF52693861	OTHER	APP ONE
3	000000077372	OTHER	GHI
4	5850533	OTHER	AETNA OUT OF NETWORK

General Provider Information

NPI Number	:	1033170931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY SETH FRIEDMAN MD

Provider Business Mailing Address
First Line	:	1 BROOKDALE PLAZA
Second Line	:	PHYSICIAN ENTERPRISE
City	:	BROOKLYN
State	:	NY
Zip	:	11212-3139
Country	:	US
Telephone Number	:	718-240-7143
Fax Number	:	718-240-5808

Provider Business Practice Location Address
First Line	:	ONE BROOKDALE PLAZA
Second Line	:	OBH PHYSICIAN ENTERPRISE
City	:	BROOKLYN
State	:	NY
Zip	:	11212-1121
Country	:	US
Telephone Number	:	718-240-5622
Fax Number	:	718-240-5808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	05/19/2020

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