Healthcare Provider Details

I. General information

NPI: 1922199678
Provider Name (Legal Business Name): DAVID LEWIS FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 W CENTURY RD 235
PARAMUS NJ
07652-1433
US

IV. Provider business mailing address

30 W CENTURY RD 235
PARAMUS NJ
07652-1433
US

V. Phone/Fax

Practice location:
  • Phone: 201-225-9440
  • Fax: 201-225-9430
Mailing address:
  • Phone: 201-225-9440
  • Fax: 201-225-9430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number112587
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: