MEDICARE: DR. JEFFREY ROBERT FRIEDMAN M.D.

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	2084F0202X	Forensic Psychiatry Physician	51517	MA
2	2084P0800X	Psychiatry Physician	51517	MA
3	2084P0805X	Geriatric Psychiatry Physician	51517	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	J02871	OTHER	MA	BLUE CROSS/ BLUE SHIELD

General Provider Information

NPI Number	:	1356308126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY ROBERT FRIEDMAN M.D.

Provider Business Mailing Address
First Line	:	875 MASSACHUSETTS AVE
Second Line	:	SUITE 51
City	:	CAMBRIDGE
State	:	MA
Zip	:	02139-3067
Country	:	US
Telephone Number	:	617-864-5560
Fax Number	:	617-864-5560

Provider Business Practice Location Address
First Line	:	875 MASSACHUSETTS AVE
Second Line	:	SUITE 51
City	:	CAMBRIDGE
State	:	MA
Zip	:	02139-3067
Country	:	US
Telephone Number	:	617-864-5560
Fax Number	:	617-864-5560

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	09/11/2025

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