Provider Demographics
NPI:1558440362
Name:FRIEDIN, ALEXANDER DALE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:DALE
Last Name:FRIEDIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 E 74TH ST
Mailing Address - Street 2:#3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3975
Mailing Address - Country:US
Mailing Address - Phone:917-287-4422
Mailing Address - Fax:
Practice Address - Street 1:484 E 74TH ST
Practice Address - Street 2:APARTMENT #3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3975
Practice Address - Country:US
Practice Address - Phone:917-287-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017277-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical