Provider Demographics
NPI:1104992783
Name:LAWRENCE FRIEMAN MD PA
Entity type:Organization
Organization Name:LAWRENCE FRIEMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-741-4242
Mailing Address - Street 1:75 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1659
Mailing Address - Country:US
Mailing Address - Phone:732-741-4242
Mailing Address - Fax:732-758-9277
Practice Address - Street 1:75 W FRONT ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1659
Practice Address - Country:US
Practice Address - Phone:732-741-4242
Practice Address - Fax:732-758-9277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02952400332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0554010001Medicare NSC
NJ0554010001Medicare ID - Type UnspecifiedPROVIDER NUMBER