Provider Demographics
NPI:1982783700
Name:FRIEDMAN, IRVING (MD)
Entity type:Individual
Prefix:DR
First Name:IRVING
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2046
Mailing Address - Country:US
Mailing Address - Phone:718-375-9400
Mailing Address - Fax:718-375-9403
Practice Address - Street 1:575 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2046
Practice Address - Country:US
Practice Address - Phone:718-375-9400
Practice Address - Fax:718-375-9403
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127617174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYO7A731Medicare ID - Type Unspecified
NYD38931Medicare UPIN
00366596Medicare ID - Type Unspecified