Healthcare Provider Details

I. General information

NPI: 1316289895
Provider Name (Legal Business Name): CYNTHIA FRIEDMAN M.D., PH.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA GINSBERG M.D., PH.D.

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 SUNRISE HWY STE 124
GREAT RIVER NY
11739-1001
US

IV. Provider business mailing address

3500 SUNRISE HIGHWAY, SUITE 124, PO BOX 9006
GREAT RIVER NY
11739-9006
US

V. Phone/Fax

Practice location:
  • Phone: 631-854-0211
  • Fax:
Mailing address:
  • Phone: 631-854-0211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number281429
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: