Provider Demographics
NPI:1609997881
Name:FRIEDENTHAL, MADELINE SHERMAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:SHERMAN
Last Name:FRIEDENTHAL
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 1:686 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2620
Mailing Address - Country:US
Mailing Address - Phone:516-374-2229
Mailing Address - Fax:516-374-8695
Practice Address - Street 1:686 BROADWAY
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2620
Practice Address - Country:US
Practice Address - Phone:516-374-2229
Practice Address - Fax:516-374-8695
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6954103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist