MEDICARE: DR. ALAN FRIED PHD

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	103T00000X	Psychologist	011416	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699729905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN FRIED PHD

Provider Business Mailing Address
First Line	:	58 CHARLES ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-2750
Country	:	US
Telephone Number	:	212-620-0488
Fax Number	:

Provider Business Practice Location Address
First Line	:	7917 18TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-1703
Country	:	US
Telephone Number	:	917-922-1751
Fax Number	:

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	07/08/2007

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