Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 16873 | MD |
Y | 2251X0800X | Physical Therapist - Orthopedic | 16873 | MD |
NPI | 1255338661 |
---|---|
Provider Name | Alyse Friedman |
First Address | Lutherville, MD 21093-6240 |
Second Address | Lutherville, MD 21093-6240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 06/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
074734300 | (05) | MD |
472317 | MAMSI (01) | MD |
P00202713 | MEDICARE RAILROAD (01) | MD |