Provider Demographics
NPI:1215408018
Name:FRIEDMAN, JOANNA (LAC)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:FERDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:24 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6440
Mailing Address - Country:US
Mailing Address - Phone:914-725-1016
Mailing Address - Fax:
Practice Address - Street 1:24 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6440
Practice Address - Country:US
Practice Address - Phone:914-725-1016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0013621171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty