Provider Demographics
NPI:1871706630
Name:EUGENE FRIEDBERG MD LLC
Entity type:Organization
Organization Name:EUGENE FRIEDBERG MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:FRIEDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-871-4778
Mailing Address - Street 1:151 E PALISADE AVE
Mailing Address - Street 2:APT A9
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2248
Mailing Address - Country:US
Mailing Address - Phone:201-871-4778
Mailing Address - Fax:201-767-6926
Practice Address - Street 1:151 E PALISADE AVE
Practice Address - Street 2:APT A9
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2248
Practice Address - Country:US
Practice Address - Phone:201-871-4778
Practice Address - Fax:201-767-6926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2007-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23146102L00000X, 2084P0800X
NY82800102L00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ457199Medicare ID - Type Unspecified