Individual
DR. JACK FRIED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
64 MIDDLE NECK RD, GREAT NECK, NY 11021-2357
(516) 482-0129
(516) 829-3126
Mailing address
64 MIDDLE NECK RD, GREAT NECK, NY 11021-2357
(516) 482-0129
(516) 829-3126
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC3468
FL
152W00000X
Optometrist
OPT4060
MA
152W00000X
Optometrist
Primary
TUV005890-1
NY
Other
Enumeration date
10/24/2005
Last updated
01/09/2024
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