MEDICARE: MR. STANLEY NELSON FRIEDMAN MD

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	2085R0202X	Diagnostic Radiology Physician	25MA03341800	NJ
2	2085R0202X	Diagnostic Radiology Physician	103677-1	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750324273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STANLEY NELSON FRIEDMAN MD

Provider Business Mailing Address
First Line	:	651 CONEY ISLAND AVENUE
Second Line	:	SUITE #C
City	:	BROOKLYN
State	:	NY
Zip	:	11218-4306
Country	:	US
Telephone Number	:	718-826-2000
Fax Number	:	718-826-2100

Provider Business Practice Location Address
First Line	:	651 CONEY ISLAND AVENUE
Second Line	:	SUITE #C
City	:	BROOKLYN
State	:	NY
Zip	:	11218-4306
Country	:	US
Telephone Number	:	718-826-2000
Fax Number	:	718-826-2100

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	12/28/2015

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