Healthcare Provider Details

I. General information

NPI: 1700052271
Provider Name (Legal Business Name): FRIEDMAN SPINE & PHYSICAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 11/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 MORRIS AVE
UNION NJ
07083-3312
US

IV. Provider business mailing address

1340 MORRIS AVE
UNION NJ
07083-3312
US

V. Phone/Fax

Practice location:
  • Phone: 908-686-4400
  • Fax: 908-686-4423
Mailing address:
  • Phone: 908-686-4400
  • Fax: 908-686-4423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DAVID B FRIEDMAN
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 908-686-4400