Provider Demographics
NPI:1134182447
Name:FRIEDMAN-UREVICH, SHARON MOIRA (MSN,RN,FNP-C, PMHNP)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:MOIRA
Last Name:FRIEDMAN-UREVICH
Suffix:
Gender:F
Credentials:MSN,RN,FNP-C, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 2ND ST
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-2433
Mailing Address - Country:US
Mailing Address - Phone:516-852-7974
Mailing Address - Fax:
Practice Address - Street 1:534 2ND ST
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-2433
Practice Address - Country:US
Practice Address - Phone:516-852-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-08
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY407107363LP0808X
NYF3330011363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02515259Medicaid
NY000000083538OtherGHI (HMO)
NYF333001OtherHIP
NM3435248OtherAETNA USHC
NY392291OtherAETNA USHC (PPO)
NY7599412OtherGHI (CBP)
NYP3131882OtherOXFORD
NYMF0787703OtherDEA
NY7599412OtherGHI (CBP)
NYF333001OtherHIP