MEDICARE: MRS. JODI FRIEDBERG RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	2023002264	NY

General Provider Information

NPI Number	:	1023429578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JODI FRIEDBERG RN

Provider Business Mailing Address
First Line	:	16 CEDARWOOD LN
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-5617
Country	:	US
Telephone Number	:	631-513-9280
Fax Number	:	613-543-0216

Provider Business Practice Location Address
First Line	:	16 CEDARWOOD LN
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-5617
Country	:	US
Telephone Number	:	631-513-9280
Fax Number	:	613-543-0216

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2014
Last Update Date	:	12/02/2025

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