MEDICARE: DR. LAURA JANINE FRIEDMAN BEECHER PH.D.

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	103T00000X	Psychologist	008523-1	NY

General Provider Information

NPI Number	:	1881794576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA JANINE FRIEDMAN BEECHER PH.D.

Provider Business Mailing Address
First Line	:	112 HUNTINGTON RD
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-3512
Country	:	US
Telephone Number	:	516-767-9368
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 S MARYLAND AVE
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-2912
Country	:	US
Telephone Number	:	516-767-1160
Fax Number	:

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

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	08/18/2010

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