Provider Demographics
NPI:1417244633
Name:BARRY & FLORENCE FRIEDBERG JCC
Entity Type:Organization
Organization Name:BARRY & FLORENCE FRIEDBERG JCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-766-4441
Mailing Address - Street 1:310 NATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-3326
Mailing Address - Country:US
Mailing Address - Phone:516-431-2929
Mailing Address - Fax:516-431-6278
Practice Address - Street 1:15 NEIL CT
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-5815
Practice Address - Country:US
Practice Address - Phone:516-766-4341
Practice Address - Fax:516-766-0513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2018-04-06
Deactivation Date:2011-08-17
Deactivation Code:
Reactivation Date:2011-10-12
Provider Licenses
StateLicense IDTaxonomies
NY00041165BCC251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)