Provider Demographics
NPI:1497065643
Name:FRIEDMAN, LINDA B (MS, SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:B
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BRADFORD HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-2158
Mailing Address - Country:US
Mailing Address - Phone:315-446-0527
Mailing Address - Fax:
Practice Address - Street 1:8199 E SENECA TPKE
Practice Address - Street 2:
Practice Address - City:MANLIUS
Practice Address - State:NY
Practice Address - Zip Code:13104-2101
Practice Address - Country:US
Practice Address - Phone:315-692-1203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002147-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002147-1OtherLICENSE
00365296OtherAMERICAN SPEECH LANGUAGE HEARING ASSOCIATION