Provider Demographics
NPI:1598980179
Name:FREEDMAN, SHARON JILL (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:JILL
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 S FULLERTON AVE APT 11
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2672
Mailing Address - Country:US
Mailing Address - Phone:973-744-2828
Mailing Address - Fax:973-655-1578
Practice Address - Street 1:543 VALLEY RD
Practice Address - Street 2:
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1881
Practice Address - Country:US
Practice Address - Phone:973-744-2828
Practice Address - Fax:973-655-1578
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3751103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist