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General NPI Number Information
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NPI Number | 1962606772
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Entity Type | Individual
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Provider Name | JOANNA L FRIED MD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | 198 E 121ST ST, 5TH FLOOR JANIAN MEDICAL
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City | NEW YORK
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State | NY
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Zip | 10035-3523
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Country | US
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Telephone | 917-575-9057
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Fax | 646-335-0662
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Provider Business Mailing Address
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Address Line | 198 E 121ST ST 5TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10035-3523
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Country | US
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Telephone | 917-575-9057
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Fax | 646-335-0662
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 241777
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License Number State | NY
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