Healthcare Provider Details

I. General information

NPI: 1699162255
Provider Name (Legal Business Name): GEOFFREY R FRIEDLANDER PMHNP, FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 TURKEY HILL RD
CORNWALL NY
12518-1618
US

IV. Provider business mailing address

29 N HAMILTON ST
POUGHKEEPSIE NY
12601-2541
US

V. Phone/Fax

Practice location:
  • Phone: 845-237-2102
  • Fax:
Mailing address:
  • Phone: 454-521-1110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF403690
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF-339407
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: