Provider Demographics
NPI:1851990220
Name:FRIEDMAN, TZVI (LAC)
Entity Type:Individual
Prefix:MR
First Name:TZVI
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 SOUTH PKWY
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07014-1223
Mailing Address - Country:US
Mailing Address - Phone:443-301-3270
Mailing Address - Fax:
Practice Address - Street 1:308 SOUTH PKWY
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07014-1223
Practice Address - Country:US
Practice Address - Phone:443-301-3270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-18
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NJAC-GTL-20-01792101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health