Provider Demographics
NPI:1487714028
Name:FRIEDMAN, DANIEL M (OD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BOAR CT
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-1402
Mailing Address - Country:US
Mailing Address - Phone:845-354-1714
Mailing Address - Fax:
Practice Address - Street 1:16334 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4912
Practice Address - Country:US
Practice Address - Phone:718-526-2332
Practice Address - Fax:718-297-3349
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002552-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist