Basic Information
| Provider Information | |||||||||
| NPI: | 1427270099 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRIEDMAN | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 87 ROUTE 17 NORTH | ||||||||
| Address2: | |||||||||
| City: | MAYWOOD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5519964450 | ||||||||
| FaxNumber: | 5519965729 | ||||||||
| Practice Location | |||||||||
| Address1: | INSTITUTE FOR CHILD DEV. HACKENSACK UNIV. MEDICAL CENTE | ||||||||
| Address2: | 30 PROSPECT AVE | ||||||||
| City: | HACKENSACK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019965270 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 10/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | 099660 | NY | N | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | 103G00000X | 35S100361300 | NJ | Y | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.