Provider Demographics
NPI:1912960139
Name:FRIEDBERG, JAY G (MD)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:G
Last Name:FRIEDBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1871
Mailing Address - Country:US
Mailing Address - Phone:215-752-3511
Mailing Address - Fax:215-752-1189
Practice Address - Street 1:172 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1871
Practice Address - Country:US
Practice Address - Phone:215-752-3511
Practice Address - Fax:215-752-1189
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015297E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE55447Medicare UPIN
PA065801Medicare ID - Type Unspecified