Healthcare Provider Details

I. General information

NPI: 1750207098
Provider Name (Legal Business Name): SEAN DAVID FRYDMAN PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 QUEENS ST STE 106
SYOSSET NY
11791-3058
US

IV. Provider business mailing address

60 QUEENS ST STE 106
SYOSSET NY
11791-3058
US

V. Phone/Fax

Practice location:
  • Phone: 516-747-1470
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP143713
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: