Provider Demographics
NPI:1689793069
Name:FRIEDMAN, TATIANA RYK (PHD)
Entity Type:Individual
Prefix:DR
First Name:TATIANA
Middle Name:RYK
Last Name:FRIEDMAN
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 1:30 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4265
Mailing Address - Country:US
Mailing Address - Phone:212-988-7499
Mailing Address - Fax:
Practice Address - Street 1:20 PARK AVE
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3893
Practice Address - Country:US
Practice Address - Phone:212-685-0619
Practice Address - Fax:212-685-0710
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015488103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3575171OtherOXFORD HEALTH PROVIDER
NYVM7041Medicare ID - Type UnspecifiedGROUP NUMBER IS WEW441