Provider Demographics
NPI:1811289143
Name:FRIDKIS, ARI LLOYD (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:ARI
Middle Name:LLOYD
Last Name:FRIDKIS
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 RIVERSIDE DR
Mailing Address - Street 2:NO 2G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4115
Mailing Address - Country:US
Mailing Address - Phone:917-617-3615
Mailing Address - Fax:
Practice Address - Street 1:320 RIVERSIDE DR
Practice Address - Street 2:NO 2G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4115
Practice Address - Country:US
Practice Address - Phone:917-617-3615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR040066-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical