Provider Demographics
NPI:1134962533
Name:FRIED, ELIMELECH (LMSW)
Entity type:Individual
Prefix:
First Name:ELIMELECH
Middle Name:
Last Name:FRIED
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LEE AVE STE 246
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-8031
Mailing Address - Country:US
Mailing Address - Phone:347-661-0418
Mailing Address - Fax:
Practice Address - Street 1:755 KENT AVE APT 506
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-8202
Practice Address - Country:US
Practice Address - Phone:347-661-0418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker