Provider Demographics
NPI:1114807591
Name:SHIRA FREUDENBERGER PSYD LLC
Entity type:Organization
Organization Name:SHIRA FREUDENBERGER PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREUDENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:973-545-6433
Mailing Address - Street 1:115 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-2410
Mailing Address - Country:US
Mailing Address - Phone:973-545-6433
Mailing Address - Fax:
Practice Address - Street 1:115 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2410
Practice Address - Country:US
Practice Address - Phone:973-545-6433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty