MEDICARE: DR. MICHELLE M FRIEDMAN OD

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	152W00000X	Optometrist	TUV007276	NY

General Provider Information

NPI Number	:	1073758413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE M FRIEDMAN OD

Provider Business Mailing Address
First Line	:	1577 E 18TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-7201
Country	:	US
Telephone Number	:	718-819-9560
Fax Number	:	347-896-5559

Provider Business Practice Location Address
First Line	:	1577 E 18TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-7201
Country	:	US
Telephone Number	:	718-819-9560
Fax Number	:	347-896-5559

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

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	08/03/2015

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