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General NPI Number Information
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NPI Number | 1205429644
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Entity Type | Individual
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Provider Name | NATHANIEL FRIEDMAN
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Gender | Male
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 382A ROUTE 59
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City | AIRMONT
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State | NY
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Zip | 10952-3439
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Country | US
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Telephone | 845-581-3380
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Fax |
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Provider Business Mailing Address
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Address Line | 382A ROUTE 59
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City | AIRMONT
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State | NY
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Zip | 10952-3439
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Country | US
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Telephone | 845-581-3380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 07448
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 062964
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License Number State | NY
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