Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD054645L | PA |
N | 2081P2900X | Pain Medicine | MD054645L | PA |
NPI | 1184739500 |
---|---|
Provider Name | Jeffrey M Friedman |
First Address | Paoli, PA 19301-1620 |
Second Address | Paoli, PA 19301-1620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 06/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000750901 | (05) | DE |
001620234 | (05) | PA |
G27760 | (02) |