MEDICARE: MRS. MELISSA ANN FRIEDMAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC05314000	NJ

General Provider Information

NPI Number	:	1669599452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA ANN FRIEDMAN LCSW

Provider Business Mailing Address
First Line	:	211 SHINNECOCK DR
Second Line	:
City	:	MANALAPAN
State	:	NJ
Zip	:	07726-9518
Country	:	US
Telephone Number	:	732-851-5124
Fax Number	:

Provider Business Practice Location Address
First Line	:	1460 LIVINGSTON AVE
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-1873
Country	:	US
Telephone Number	:	732-729-3600
Fax Number	:	732-435-0222

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2007
Last Update Date	:	07/08/2007

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