Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | OS010268 | PA |
NPI | 1275525040 |
---|---|
Provider Name | Harlee A Fried |
First Address | Middletown, NY 10941-4018 |
Second Address | Middletown, NY 10941-4018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2005 |
Last Update Date | 10/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001780659 0002 | (05) | PA |
1475841 | (05) | NY |
E81196 | (02) |