Basic Information
Provider Information
NPI: 1003018730
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRIEDLANDER
FirstName: JOEL
MiddleName: A.
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 110429
Address2:  
City: AURORA
State: CO
PostalCode: 800420429
CountryCode: US
TelephoneNumber: 3034937000
FaxNumber:  
Practice Location
Address1: 13123 E 16TH AVE
Address2:  
City: AURORA
State: CO
PostalCode: 800457106
CountryCode: US
TelephoneNumber: 7207771234
FaxNumber: 7207777277
Other Information
ProviderEnumerationDate: 06/04/2007
LastUpdateDate: 06/12/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XOS013734PAN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0206XDO29046ORN Allopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
2080P0206XOP60135971WAN Allopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
2080P0206XOS013734PAN Allopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
2080P0206XDR-50219COY Allopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology

ID Information
IDTypeStateIssuerDescription
4702435605CO MEDICAID


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