Basic Information
| Provider Information | |||||||||
| NPI: | 1609852326 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRIEND | ||||||||
| FirstName: | TODD | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 WESTCHESTER AVE | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106042901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146813146 | ||||||||
| FaxNumber: | 9146826403 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 WESTCHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106042901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146826511 | ||||||||
| FaxNumber: | 9146826403 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2005 | ||||||||
| LastUpdateDate: | 10/16/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 195971 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 000475 | CT | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 509437 | 01 | NY | PHCS | OTHER | 133884168 | 01 | NY | BEECH STREET | OTHER | P612661 | 01 | NY | OXFORD | OTHER | 1022682 | 01 | NY | AETNA HMO | OTHER | 133884168 | 01 | NY | POMCO | OTHER | 592781/592783 | 01 | NY | BLUE CROSS PPO | OTHER | 01781873 | 05 | NY | MEDICAID | 1798736 | 01 | NY | UNITED HEALTH CARE | OTHER | 5823412 | 01 | NY | AETNA NON HMO | OTHER | 000000045833 | 01 | NY | GHI HMO | OTHER | 195971 | 01 | NY | HIP | OTHER | 0D1268 | 01 | NY | HEALTH NET | OTHER | 133884168 | 01 | NY | MULTIPLAN | OTHER | 6101275 | 01 | NY | GHI PPO | OTHER | 6953913-008 | 01 | NY | CIGNA (PCP) | OTHER | 773388 | 01 | NY | CONNECTICARE | OTHER | 133884168 | 01 | NY | EMPIRE STATE PLAN (NYS) | OTHER |