1093267155 NPI number — FRIEL PROSTHETICS INC., DBA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093267155 NPI number — FRIEL PROSTHETICS INC., DBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRIEL PROSTHETICS INC., DBA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093267155
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/25/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 N WOLFE ST
Provider Second Line Business Mailing Address:
MAUMENEE 505
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21287-0005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-955-1113
Provider Business Mailing Address Fax Number:
301-652-7585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4845 RUGBY AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20814-3018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-652-9282
Provider Business Practice Location Address Fax Number:
301-652-7585
Provider Enumeration Date:
10/25/2016

Additional Information

Authorized Official

Authorized Official Last Name:
FRIEL
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
P
Authorized Official Title or Position:
PRESIDENT/ OCULARIST
Authorized Official Telephone Number:
301-652-9282

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 453204000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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