Provider Demographics
NPI:1972708139
Name:FRIEDEL, MARK ERIK (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ERIK
Last Name:FRIEDEL
Suffix:
Gender:
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5187
Mailing Address - Country:US
Mailing Address - Phone:914-333-5801
Mailing Address - Fax:
Practice Address - Street 1:200 BOWMAN DRIVE
Practice Address - Street 2:SUITE D-285
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-9626
Practice Address - Country:US
Practice Address - Phone:856-576-5746
Practice Address - Fax:856-519-5295
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09273800207Y00000X
PAMD444624207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102718758Medicaid
NJ0308951Medicaid
PA102718758Medicaid
NJ0308951Medicaid