MEDICARE: MS. HARRIET FRIEDMAN-WILSON MS

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	231H00000X	Audiologist	563	NY

General Provider Information

NPI Number	:	1093986044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HARRIET FRIEDMAN-WILSON MS

Provider Business Mailing Address
First Line	:	1887 RICHMOND AVE
Second Line	:	SUITE V
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3923
Country	:	US
Telephone Number	:	718-370-0072
Fax Number	:	718-370-6733

Provider Business Practice Location Address
First Line	:	1887 RICHMOND AVE
Second Line	:	SUITE V
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3923
Country	:	US
Telephone Number	:	718-370-0072
Fax Number	:	718-370-6733

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

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	01/05/2009

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