Provider Demographics
NPI:1669673307
Name:FRIEDMAN, ELAINE DORIS (PSYD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:DORIS
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HARWOOD CT
Mailing Address - Street 2:STE 305
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-723-6161
Mailing Address - Fax:
Practice Address - Street 1:14 HARWOOD CT
Practice Address - Street 2:STE 305
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-723-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008565NEWYORK103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWS1135OtherOXFORD HEALTH PLANS
NY0072379OtherGHI
NYWS1135OtherOXFORD HEALTH PLANS