Provider Demographics
NPI:1508381781
Name:FRIEDMAN, LAURA (ATC-L)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:ATC-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1124
Mailing Address - Country:US
Mailing Address - Phone:732-663-9551
Mailing Address - Fax:
Practice Address - Street 1:667 WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-2120
Practice Address - Country:US
Practice Address - Phone:908-889-8600
Practice Address - Fax:908-889-0253
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000416002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer