Fried, Gordon W
Fried, Gordon W is an sole proprietor health care provider with primary practice located at 200 Plaza Ct Suite C, East Stroudsburg PA 18301-8259. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Fried, Gordon W can be contacted via phone (570) 424-9952.Contact Information
Primary practice address
200 Plaza Ct Suite C
East Stroudsburg PA 18301-8259
Phone: (570) 424-9952
Fax: (570) 424-0768
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | OS-007213-E | Pennsylvania |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | OS007213E | Pennsylvania |
Profile Details
| NPI number | 1134126840 |
|---|---|
| LBN Legal business name | Fried, Gordon W |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Apr 29th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134126840 | NPPES |
| Pennsylvania | MEDICAID | 0012090750005 | |
| Pennsylvania | Other | 0457628 | |
| Pennsylvania | Other | 232725862 | |
| Pennsylvania | Other | 075227 | |
| Pennsylvania | Other | 2101332 |
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