Provider Demographics
NPI:1689398554
Name:FREEDMAN, DAVID CRAIG (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CRAIG
Last Name:FREEDMAN
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 1:200 E 17TH ST APT 1J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4636
Mailing Address - Country:US
Mailing Address - Phone:917-741-1479
Mailing Address - Fax:
Practice Address - Street 1:200 E 17TH ST APT 1J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4636
Practice Address - Country:US
Practice Address - Phone:917-741-1479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025287103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical