Healthcare Provider Details

I. General information

NPI: 1285715219
Provider Name (Legal Business Name): HENRY M FRIEDMAN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 03/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6509 DEMOCRACY BLVD
BETHESDA MD
20817-1639
US

IV. Provider business mailing address

6509 DEMOCRACY BLVD
BETHESDA MD
20817-1639
US

V. Phone/Fax

Practice location:
  • Phone: 301-897-5210
  • Fax:
Mailing address:
  • Phone: 301-588-1813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA00805
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberTA00805
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberTA00805
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: