Provider Demographics
NPI:1982028106
Name:FRIEDBERG, ALAN JEFFREY (MT-BC, LCAT)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:JEFFREY
Last Name:FRIEDBERG
Suffix:
Gender:M
Credentials:MT-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 TOMPKINS AVE
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-1323
Mailing Address - Country:US
Mailing Address - Phone:845-642-0859
Mailing Address - Fax:
Practice Address - Street 1:117 DEPEW AVE
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3707
Practice Address - Country:US
Practice Address - Phone:845-642-0859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001747-1225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist