Provider Demographics
NPI:1881794576
Name:BEECHER, LAURA JANINE FRIEDMAN (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JANINE FRIEDMAN
Last Name:BEECHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 HUNTINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3512
Mailing Address - Country:US
Mailing Address - Phone:516-767-9368
Mailing Address - Fax:
Practice Address - Street 1:17 S MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-2912
Practice Address - Country:US
Practice Address - Phone:516-767-1160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008523-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist