Provider Demographics
NPI:1124870506
Name:FRIEDMAN, GREGORY (NP)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 EASTERN PKWY APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-3660
Mailing Address - Country:US
Mailing Address - Phone:347-446-6688
Mailing Address - Fax:
Practice Address - Street 1:935 EASTERN PKWY APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3660
Practice Address - Country:US
Practice Address - Phone:347-446-6688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF345032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner