Provider Demographics
NPI:1053335000
Name:FRIDMAN, MAINA (PHD, LCSW-R, ACSW)
Entity type:Individual
Prefix:DR
First Name:MAINA
Middle Name:
Last Name:FRIDMAN
Suffix:
Gender:F
Credentials:PHD, LCSW-R, ACSW
Other - Prefix:
Other - First Name:MAINA
Other - Middle Name:
Other - Last Name:KATS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15-08 LANDZETTEL WAY
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-5916
Mailing Address - Country:US
Mailing Address - Phone:201-794-3660
Mailing Address - Fax:212-543-4581
Practice Address - Street 1:1 CABRINI BLVD
Practice Address - Street 2:# 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-5410
Practice Address - Country:US
Practice Address - Phone:212-543-4572
Practice Address - Fax:212-543-4581
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR048000-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN60R61Medicare PIN