Provider Demographics
NPI:1760481949
Name:FRIEDMAN, KIMBERLY K (OD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:K
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N CHURCH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-2498
Mailing Address - Country:US
Mailing Address - Phone:856-235-2620
Mailing Address - Fax:856-235-0842
Practice Address - Street 1:301 N CHURCH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2498
Practice Address - Country:US
Practice Address - Phone:856-235-2620
Practice Address - Fax:856-235-0842
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA 05126152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223294272-009OtherCIGNA
NJ22838OtherAMERIGROUP
NJ2K6645OtherHEALTHNET
NJ5021201Medicaid
NJ0945160001OtherDMERC
NJ113989OtherAETNA
NJ223294272-009OtherCIGNA
NJU34909Medicare UPIN