Healthcare Provider Details

I. General information

NPI: 1376119636
Provider Name (Legal Business Name): ALBERTO FRIEDMANN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 LOCUST ST APT 1106
SAINT LOUIS MO
63101-1358
US

IV. Provider business mailing address

1014 LOCUST ST APT 1106
SAINT LOUIS MO
63101-1358
US

V. Phone/Fax

Practice location:
  • Phone: 618-580-8453
  • Fax:
Mailing address:
  • Phone: 618-580-8453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: