Basic Information
Provider Information
NPI: 1326067885
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRIEDMAN
FirstName: DANIEL
MiddleName: LAWRENCE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 853 7TH AVE
Address2: APT 10-D
City: NEW YORK
State: NY
PostalCode: 100195215
CountryCode: US
TelephoneNumber: 9175832329
FaxNumber:  
Practice Location
Address1: 423 E 23RD ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100105011
CountryCode: US
TelephoneNumber: 2126867500
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/18/2006
LastUpdateDate: 09/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X0101057427VAN Allopathic & Osteopathic PhysiciansInternal Medicine 
2084P0800X229408NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

ID Information
IDTypeStateIssuerDescription
0254694505NY MEDICAID


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