Provider Demographics
NPI:1184950131
Name:FRIEDMAN, STEFANIE
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:
Other - Last Name:MOSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:915 CENTRAL AVE
Mailing Address - Street 2:3F
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4602
Mailing Address - Country:US
Mailing Address - Phone:323-251-7042
Mailing Address - Fax:
Practice Address - Street 1:1273 53RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3845
Practice Address - Country:US
Practice Address - Phone:718-435-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker