Provider Demographics
NPI:1528054137
Name:FRIEDLANDER, RICHARD PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PAUL
Last Name:FRIEDLANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:PAUL
Other - Last Name:FRIEDLANDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1056 5TH AVE
Mailing Address - Street 2:10C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0112
Mailing Address - Country:US
Mailing Address - Phone:917-846-9853
Mailing Address - Fax:413-832-4638
Practice Address - Street 1:11115 QUEENS BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7422
Practice Address - Country:US
Practice Address - Phone:718-268-3333
Practice Address - Fax:413-832-4638
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120328207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00971408Medicaid
NY00971408Medicaid
NYA78462Medicare UPIN
NY85180Medicare ID - Type UnspecifiedGHI-MEDICARE