Provider Demographics
NPI:1679802847
Name:FRIEDMAN, NAOMI (R-PA)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:R-PA
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:301 E 75TH ST APT 12B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3020
Mailing Address - Country:US
Mailing Address - Phone:917-885-9409
Mailing Address - Fax:
Practice Address - Street 1:301 E 75TH ST APT 12B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3020
Practice Address - Country:US
Practice Address - Phone:917-885-9409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003298363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical