Healthcare Provider Details

I. General information

NPI: 1760419659
Provider Name (Legal Business Name): TERRY D FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 ROUTE 70 E
CHERRY HILL NJ
08034-2230
US

IV. Provider business mailing address

1400 ROUTE 70 E
CHERRY HILL NJ
08034-2230
US

V. Phone/Fax

Practice location:
  • Phone: 856-216-0300
  • Fax: 856-216-7142
Mailing address:
  • Phone: 856-216-0300
  • Fax: 856-216-7142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberMD020895E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: