Provider Demographics
NPI:1407851900
Name:FRIEDMAN, STACY MICHELE (OD)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:MICHELE
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:STACY
Other - Middle Name:FRIEDMAN
Other - Last Name:PINSKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:420 E 61ST ST
Mailing Address - Street 2:APT 10E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-8772
Mailing Address - Country:US
Mailing Address - Phone:917-848-6445
Mailing Address - Fax:
Practice Address - Street 1:33 W 42ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-8003
Practice Address - Country:US
Practice Address - Phone:917-848-6445
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT006570-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist