1376649707 NPI number — HEATHER NAOMI FRIEDMAN-COHEN MD

Table of content: HEATHER NAOMI FRIEDMAN-COHEN MD (NPI 1376649707)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376649707 NPI number — HEATHER NAOMI FRIEDMAN-COHEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRIEDMAN-COHEN
Provider First Name:
HEATHER
Provider Middle Name:
NAOMI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRIEDMAN
Provider Other First Name:
HEATHER
Provider Other Middle Name:
NAOMI
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1376649707
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 37215
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21297-7215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-590-5152
Provider Business Mailing Address Fax Number:
212-590-5798

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 MICHIGAN AVENUE NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20010-2978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-746-0780
Provider Business Practice Location Address Fax Number:
212-746-4883
Provider Enumeration Date:
09/15/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  240505 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207PP0204X , with the licence number: 240505 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: 240505 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 02785197 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".