Provider Demographics
NPI:1558023515
Name:GLEIBERMAN, FRAIDA ALIZA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:FRAIDA
Middle Name:ALIZA
Last Name:GLEIBERMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 5TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3264
Mailing Address - Country:US
Mailing Address - Phone:848-525-3061
Mailing Address - Fax:
Practice Address - Street 1:1525 PROSPECT ST STE 206
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4662
Practice Address - Country:US
Practice Address - Phone:198-961-7413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTL3649235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist