MEDICARE: DR. RICHARD FRIEDMAN MSW, PHD

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	PR022094-1	NY

General Provider Information

NPI Number	:	1427034453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD FRIEDMAN MSW, PHD

Provider Business Mailing Address
First Line	:	1123 PARK AVE
Second Line	:	SUITE 1-D
City	:	NEW YORK
State	:	NY
Zip	:	10128-1241
Country	:	US
Telephone Number	:	212-289-3592
Fax Number	:	212-289-7626

Provider Business Practice Location Address
First Line	:	1123 PARK AVE
Second Line	:	SUITE 1-D
City	:	NEW YORK
State	:	NY
Zip	:	10128-1241
Country	:	US
Telephone Number	:	212-289-3592
Fax Number	:	212-289-7626

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

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	08/04/2010

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