Provider Demographics
NPI:1730282955
Name:FRIEDMAN, SUSAN (MSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 VALLEY GREENS DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-3634
Mailing Address - Country:US
Mailing Address - Phone:516-791-8982
Mailing Address - Fax:718-544-1254
Practice Address - Street 1:31 VALLEY GREENS DR
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-3634
Practice Address - Country:US
Practice Address - Phone:516-791-8982
Practice Address - Fax:718-544-1254
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR019262-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7404977OtherGHI
NYDS539OtherOXFORD HEALTH PLANS
NY081795OtherVALUE OPTIONS
NY179174OtherMANAGED HEALTH NETWORK
NYN0I771OtherEMPIRE BLUE CROSS
NY0905968OtherUSHEALTHCARE
NY12999POtherHIP
NY081795OtherVALUE OPTIONS