Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | NY |
NPI | 1093852071 |
---|---|
Provider Name | Jeffrey Friedman |
First Address | Howard Beach, NY 11414-3431 |
Second Address | Howard Beach, NY 11414-3431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 13/03/2020 |