Provider Demographics
NPI:1033208038
Name:FRIEDMAN, JUDITH MELTZER (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:MELTZER
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 TERRACEVIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214
Mailing Address - Country:US
Mailing Address - Phone:315-446-4504
Mailing Address - Fax:315-449-0649
Practice Address - Street 1:122 TERRACEVIEW RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-1214
Practice Address - Country:US
Practice Address - Phone:315-446-4504
Practice Address - Fax:315-449-0649
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR147120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health