Provider Demographics
NPI:1801037114
Name:FREIDL, EVE KHLYAVICH (MD)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:KHLYAVICH
Last Name:FREIDL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:CHONY 6N, ROOM 619
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-543-0919
Mailing Address - Fax:212-543-5966
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:CHONY 6N, ROOM 619
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-543-0919
Practice Address - Fax:212-543-5966
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2010-10-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY251837-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry