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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134126840 NPPES
Pennsylvania MEDICAID 0012090750005
Pennsylvania Other 0457628
Pennsylvania Other 232725862
Pennsylvania Other 075227
Pennsylvania Other 2101332

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