| Amy L Friedenthal Md Pc | |
|
12512 Lake Ridge Dr Ste D Lake Ridge VA 22192-2386 | |
| (703) 497-5555 | |
| (703) 497-1479 |
| Full Name | Amy L Friedenthal Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12512 Lake Ridge Dr Ste D, Lake Ridge, Virginia |
| Authorized Official Name and Position | Amy Friedenthal (PHYSICIAN) |
| Authorized Official Contact | 7034975555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy L Friedenthal Md Pc 12512 Lake Ridge Dr Ste D Lake Ridge VA 22192-2386 Ph: (703) 497-5555 | Amy L Friedenthal Md Pc 12512 Lake Ridge Dr Ste D Lake Ridge VA 22192-2386 Ph: (703) 497-5555 |
| NPI Number | 1174722664 |
|---|---|
| Provider Enumeration Date | 07/13/2007 |
| Last Update Date | 07/13/2007 |
| Medicare PECOS PAC ID | 2365344934 |
|---|---|
| Medicare Enrollment ID | O20040123000446 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174722664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Amy Friedenthal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427176999 PECOS PAC ID: 5395647960 Enrollment ID: I20040123000611 |
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