Provider Demographics
NPI:1457651812
Name:FRIEDMAN, FRAYDA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:FRAYDA
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 CORONADO ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2210
Mailing Address - Country:US
Mailing Address - Phone:732-232-7361
Mailing Address - Fax:732-886-8251
Practice Address - Street 1:1242 CORONADO ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2210
Practice Address - Country:US
Practice Address - Phone:732-232-7361
Practice Address - Fax:732-886-8251
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00524600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist