MEDICARE: MARINA FRIEDMAN

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	163W00000X	Registered Nurse	RN2298679	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN2298679	OTHER	MA	NURSING
2	RN2298679	OTHER	MA	NURSIN
3	RN2298670	OTHER	MA	NURSING

General Provider Information

NPI Number	:	1235625120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINA FRIEDMAN

Provider Business Mailing Address
First Line	:	26 WARREN ST
Second Line	:
City	:	PEABODY
State	:	MA
Zip	:	01960-4304
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 WARREN ST
Second Line	:
City	:	PEABODY
State	:	MA
Zip	:	01960-4304
Country	:	US
Telephone Number	:	617-584-5331
Fax Number	:

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

Provider Enumeration Date	:	07/03/2018
Last Update Date	:	07/03/2018

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Directions to “ MARINA FRIEDMAN ” Practice Location

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