Provider Demographics
NPI:1861575391
Name:FRIEDMAN, ALLAN (DPM)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:ALLAN
Other - Middle Name:
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:8705 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-2037
Mailing Address - Country:US
Mailing Address - Phone:718-441-6550
Mailing Address - Fax:718-441-6993
Practice Address - Street 1:87-05 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2037
Practice Address - Country:US
Practice Address - Phone:718-441-6550
Practice Address - Fax:718-441-6993
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003083213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT31810Medicare UPIN