Provider Demographics
NPI:1194712257
Name:FRIEDMAN, NEAL (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:77 WARREN ST
Mailing Address - Street 2:ROOM 339
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3601
Mailing Address - Country:US
Mailing Address - Phone:617-562-5359
Mailing Address - Fax:617-562-5415
Practice Address - Street 1:24 COMMON STREET
Practice Address - Street 2:SUITE #1
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093
Practice Address - Country:US
Practice Address - Phone:508-384-2223
Practice Address - Fax:508-384-8372
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA48087207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0193677Medicaid
MA0193677Medicaid
B73293Medicare UPIN