Basic Information
| Provider Information | |||||||||
| NPI: | 1184836660 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRIEDRICH | ||||||||
| FirstName: | ALICE | ||||||||
| MiddleName: | DAWN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ANP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 57 KETCHAM AVENUE | ||||||||
| Address2: | |||||||||
| City: | AMITYVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316915456 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 43 CROSSWAYS PARK DRIVE | ||||||||
| Address2: | |||||||||
| City: | WOODBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11797 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5169383000 | ||||||||
| FaxNumber: | 5169925219 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2007 | ||||||||
| LastUpdateDate: | 06/25/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0200X | F301906-1 | NY | N | Nursing Service Providers | Registered Nurse | Critical Care Medicine | 363LA2200X | F301906-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.