Organization Active NPI

Jennifer Friedman OD PC

  • Optometrist
  • Danbury, CT
National Provider Identifier
1962717678
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV007411 Issued in NY
Legal business name
JENNIFER FRIEDMAN OD PC
Practice address
7 Backus Ave
Danbury Fair Mall
Danbury, CT 06810-7422
Phone
(203) 790-1341
Fax
(203) 790-5052
NPI assigned
Aug 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Authorized official

Name
Jennifer Friedman, OD
Title
Owner
Phone
(212) 729-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV007411 NY Primary

Addresses

Primary practice location

7 Backus Ave
Danbury Fair Mall
Danbury, CT 06810-7422

Mailing address

75 Wall St
New York, NY 10005-2833
Phone (212) 729-5300

Other identifiers 1

IdentifierTypeStateIssuer
03225638MedicaidNY

National Provider Directory

National Provider Directory

Locations

75 Wall St
New York, NY 10005

NPI Registry JSON

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1962717678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 WALL ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100052833",
            "telephone_number": "212-729-5300",
            "fax_number": "212-729-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BACKUS AVE",
            "address_2": "DANBURY FAIR MALL",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107422",
            "telephone_number": "203-790-1341",
            "fax_number": "203-790-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER FRIEDMAN OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-18",
        "last_updated": "2010-08-18",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-729-5300",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV007411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03225638",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.