MEDICARE: DANIEL FRIEDLANDER

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	2255A2300X	Athletic Trainer	002884	NY

General Provider Information

NPI Number	:	1841657996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL FRIEDLANDER

Provider Business Mailing Address
First Line	:	17 ALLAN RD
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-1001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 N SALEM RD
Second Line	:
City	:	CROSS RIVER
State	:	NY
Zip	:	10518-1104
Country	:	US
Telephone Number	:	914-763-7485
Fax Number	:

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

Provider Enumeration Date	:	01/20/2016
Last Update Date	:	01/20/2016

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