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General NPI Number Information
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NPI Number | 1417244633
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Entity Type | Organization
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Legal Business Name | BARRY & FLORENCE FRIEDBERG JCC
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 04/06/2018
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Provider Practice Location Address
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Address Line | 15 NEIL CT
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City | OCEANSIDE
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State | NY
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Zip | 11572-5815
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Country | US
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Telephone | 516-766-4341
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Fax | 516-766-0513
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Provider Business Mailing Address
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Address Line | 310 NATIONAL BLVD
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City | LONG BEACH
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State | NY
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Zip | 11561-3326
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Country | US
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Telephone | 516-431-2929
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Fax | 516-431-6278
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Authorized Official
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Title or Position | SENIOR PROGRAM DIRECTOR
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Name | MARCY HALLERMAN
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Credential |
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Telephone | 516-766-4441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 00041165BCC
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License Number State | NY
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