Provider Demographics
NPI: | 1972996627 |
---|---|
Name: | BEER FRIEDRICH MD PC |
Entity type: | Organization |
Organization Name: | BEER FRIEDRICH MD PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CONTROLLER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FRIEDRICH |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 718-343-4273 |
Mailing Address - Street 1: | 200 W 57TH ST STE 200 |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10019-3211 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-343-4273 |
Mailing Address - Fax: | 718-343-4273 |
Practice Address - Street 1: | 200 W 57TH ST STE 200 |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10019-3211 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-343-4273 |
Practice Address - Fax: | 718-343-4273 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-03-05 |
Last Update Date: | 2015-03-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 207W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Single Specialty |