Bruce Lee Friedman, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X003337 Issued in NY

Practice address

430 S Marginal Rd
Jericho, NY 11753-1914

Phone

(516) 937-3409

Fax

(516) 932-8743

NPI assigned

Oct 4, 2006

Last updated

Mar 7, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elite Chiropractic, PC

  • Chiropractor
  • Jericho, NY
  • NPI 1760767578
  Authorized official Same address or phone
• Jericho Fire District

  • Land Ambulance
  • Jericho, NY
  • NPI 1164134060
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1770678773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 S MARGINAL RD",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531914",
            "telephone_number": "516-937-3409",
            "fax_number": "516-932-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S MARGINAL RD",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531914",
            "telephone_number": "516-937-3409",
            "fax_number": "516-932-8743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "BRUCE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X003337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A400058122",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faye Grand, Otr L CHT (Hand Therapy Centers)
• Gabriella Irene Ficarra
• Eileen Finke
• Regina Marie Finta, AUD
• Form and Function Physical Therapy PC.
• Clyde Friedman, M.S.W., L.C.S.W.
• Amanda Frobosilo
• Jennifer Gabriele Desivo
• Danielle Rose Gambino
• Ashleigh Garretson, PSY.D.

• Chiropractor in Jericho, NY
• Providers in Jericho, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.