Provider Demographics
NPI:1134374135
Name:FRIEDMAN, CAROLE A (MACCCSLP)
Entity type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:A
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:MACCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 ILLONA LN
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5427
Mailing Address - Country:US
Mailing Address - Phone:516-546-3104
Mailing Address - Fax:516-546-0295
Practice Address - Street 1:2106 ILLONA LN
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-5427
Practice Address - Country:US
Practice Address - Phone:516-546-3104
Practice Address - Fax:516-546-0295
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006259235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist