Healthcare Provider Details

I. General information

NPI: 1003980418
Provider Name (Legal Business Name): JOSEPH IRWIN FRIEDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 CROOKED HILL ROAD PILGRIM PSYCHIATRIC CENTER BUILDING 47 THIRD FLOOR
W BRENTWOOD NY
11717
US

IV. Provider business mailing address

235 EAST 95TH STREET APARTMENT 14F
NEW YORK NY
10128
US

V. Phone/Fax

Practice location:
  • Phone: 631-761-3607
  • Fax: 631-761-2718
Mailing address:
  • Phone: 212-369-9758
  • Fax: 212-369-9758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number194791
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: