Provider Demographics
NPI:1891822680
Name:FRIEDLAND, STANLEY BURT (PHD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:BURT
Last Name:FRIEDLAND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MORGAN PL
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-4930
Mailing Address - Country:US
Mailing Address - Phone:914-948-6785
Mailing Address - Fax:914-683-0806
Practice Address - Street 1:24 MORGAN PL
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-4930
Practice Address - Country:US
Practice Address - Phone:914-948-6785
Practice Address - Fax:914-683-0806
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007266103TA0700X, 103TB0200X, 103TC0700X, 103TF0000X, 103TH0100X, 103T00000X
NY000359106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004152055Medicaid
NY01036488Medicaid
CT004152055Medicaid
NY01036488Medicaid
CT680000642Medicare ID - Type Unspecified