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General NPI Number Information
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NPI Number | 1962717678
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Entity Type | Organization
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Legal Business Name | JENNIFER FRIEDMAN OD PC
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 08/18/2010
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Provider Practice Location Address
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Address Line | 7 BACKUS AVE DANBURY FAIR MALL
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City | DANBURY
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State | CT
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Zip | 06810-7422
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Country | US
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Telephone | 203-790-1341
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Fax | 203-790-5052
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Provider Business Mailing Address
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Address Line | 75 WALL ST
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City | NEW YORK
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State | NY
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Zip | 10005-2833
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Country | US
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Telephone | 212-729-5300
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Fax | 212-729-5382
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER FRIEDMAN
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Credential | OD
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Telephone | 212-729-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV007411
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License Number State | NY
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