Provider Demographics
NPI:1891053237
Name:FRIEL, CARISA (MA, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MRS
First Name:CARISA
Middle Name:
Last Name:FRIEL
Suffix:
Gender:F
Credentials:MA, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S CARLL AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-3402
Mailing Address - Country:US
Mailing Address - Phone:631-482-1565
Mailing Address - Fax:
Practice Address - Street 1:1225 FRANKLIN AVE
Practice Address - Street 2:SUITE 325
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-1691
Practice Address - Country:US
Practice Address - Phone:516-512-8905
Practice Address - Fax:866-541-7770
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018807-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist