Healthcare Provider Details

I. General information

NPI: 1962445809
Provider Name (Legal Business Name): SUSAN M. FRIEDMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/05/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH AVE BOX 58
ROCHESTER NY
14620-2733
US

IV. Provider business mailing address

1000 SOUTH AVE BOX 58
ROCHESTER NY
14620-2733
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-6779
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number219442
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number219442-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: