Provider Demographics
NPI:1841963147
Name:FRIEDMAN, ELIANA (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:ELIANA
Middle Name:
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SKYLARK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1312
Mailing Address - Country:US
Mailing Address - Phone:845-521-4930
Mailing Address - Fax:
Practice Address - Street 1:16 SKYLARK DR
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1312
Practice Address - Country:US
Practice Address - Phone:845-521-4930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-01
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY715262-01163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant