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General NPI Number Information
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NPI Number | 1902889835
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Entity Type | Individual
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Provider Name | TERRI R FRIED MD
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Gender | Female
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 789 HOWARD AVE DANA BUILDING - 3RD FLOOR
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City | NEW HAVEN
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State | CT
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Zip | 06519-1304
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Country | US
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Telephone | 203-688-6361
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Fax | 203-688-4209
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Provider Business Mailing Address
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Address Line | 50 DIVISION ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-1936
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Country | US
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Telephone | 203-785-6610
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Fax | 203-785-6414
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 034622
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 034622
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License Number State | CT
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