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NPI Code Detail

MEDICARE: MS. ELLEN FRIEDMAN CASAC

MEDICARE: MS. ELLEN FRIEDMAN CASAC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor025871NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366770877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELLEN FRIEDMAN CASAC
Provider Business Mailing Address
First Line : 651 VANDERBILT ST APT 7M
Second Line :
City : BROOKLYN
State : NY
Zip : 11218-7202
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 810 CLASSON AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11238-6102
Country : US
Telephone Number : 718-230-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2009
Last Update Date : 04/18/2018

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Directions to “ MS. ELLEN FRIEDMAN CASAC” Practice Location

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