Provider Demographics
NPI:1912069865
Name:FRANKLIN P FRIEDMAN MD PC
Entity type:Organization
Organization Name:FRANKLIN P FRIEDMAN MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-886-1956
Mailing Address - Street 1:330 WASHINGTON STREET
Mailing Address - Street 2:SUITE 350
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2700
Mailing Address - Country:US
Mailing Address - Phone:860-886-1956
Mailing Address - Fax:860-887-2048
Practice Address - Street 1:330 WASHINGTON STREET
Practice Address - Street 2:SUITE 350
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2700
Practice Address - Country:US
Practice Address - Phone:860-886-1956
Practice Address - Fax:860-887-2048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DA3256OtherRAILROAD MEDICARE GROUP
CT1139039Medicaid
CTC02277OtherPTAN
C02277Medicare ID - Type Unspecified