MEDICARE: MRS. NANCY FRIEDMAN

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	235Z00000X	Speech-Language Pathologist	014946-1	NY

General Provider Information

NPI Number	:	1689117103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY FRIEDMAN

Provider Business Mailing Address
First Line	:	526 W SADDLE RIVER RD
Second Line	:
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-2014
Country	:	US
Telephone Number	:	917-584-8193
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 MORNINGSIDE DR
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-6017
Country	:	US
Telephone Number	:	212-690-5807
Fax Number	:

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

Provider Enumeration Date	:	12/01/2016
Last Update Date	:	12/01/2016

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Directions to “ MRS. NANCY FRIEDMAN ” Practice Location

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