Provider Demographics
NPI:1518030774
Name:FRIEDMAN, RONALD SHELDON (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:SHELDON
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-1103
Mailing Address - Country:US
Mailing Address - Phone:914-698-2898
Mailing Address - Fax:914-698-2898
Practice Address - Street 1:6 COUNTRY LN
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1103
Practice Address - Country:US
Practice Address - Phone:914-698-2898
Practice Address - Fax:914-698-2898
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004983-1103TC0700X, 103TC2200X, 103T00000X, 103TP2701X
NY103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV20301Medicare ID - Type UnspecifiedMEDICARE PROVIDER I.D.