Provider Demographics
NPI:1194893750
Name:FRIEDER, STEVEN E (PT)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:E
Last Name:FRIEDER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HAMPSHIRE RD.
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1230
Mailing Address - Country:US
Mailing Address - Phone:516-487-6846
Mailing Address - Fax:516-466-1807
Practice Address - Street 1:111 HAMPSHIRE RD.
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-1280
Practice Address - Country:US
Practice Address - Phone:516-487-6846
Practice Address - Fax:516-466-1807
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0087171225100000X
NY008717-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ55142Medicare UPIN
Q55142Medicare UPIN