Provider Demographics
NPI:1316959364
Name:FREINDLICH, BRIAN W (DC)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:W
Last Name:FREINDLICH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 BROADWAY
Mailing Address - Street 2:202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-5007
Mailing Address - Country:US
Mailing Address - Phone:212-354-2225
Mailing Address - Fax:212-354-1954
Practice Address - Street 1:19413 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3032
Practice Address - Country:US
Practice Address - Phone:718-428-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010274111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor