Provider Demographics
NPI:1427270099
Name:FRIEDMAN, CAROL ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANN
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 ROUTE 17 NORTH
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607
Mailing Address - Country:US
Mailing Address - Phone:551-996-4450
Mailing Address - Fax:551-996-5729
Practice Address - Street 1:INSTITUTE FOR CHILD DEV. HACKENSACK UNIV. MEDICAL CENTE
Practice Address - Street 2:30 PROSPECT AVE
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-996-5270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099660103G00000X
NJ35S100361300103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist