Provider Demographics
NPI:1588686182
Name:FRIEDLAND, ERIC MITCHELL (MS CCC-SLP, SLS)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:MITCHELL
Last Name:FRIEDLAND
Suffix:
Gender:M
Credentials:MS CCC-SLP, SLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WOODPORT RD STE 2G
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2415
Mailing Address - Country:US
Mailing Address - Phone:201-247-4419
Mailing Address - Fax:973-506-6837
Practice Address - Street 1:17 WOODPORT RD STE 2G
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2415
Practice Address - Country:US
Practice Address - Phone:201-247-4419
Practice Address - Fax:973-506-6837
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJYS0410260400235Z00000X
NJ41YS00260400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3170904OtherAETNA HMO
2308875OtherUNITED HEALTHCARE
223637010OtherFIRST MCO
223637010OtherUNITED HEALTHCARE
2659159OtherCIGNA PPO HMO
2236732000OtherAMERIHEALTH PIN
2239674000OtherAMERIHEALTH GROUP
2K6509OtherHEALTH NET
3424157OtherAETNA OPEN
071951S07OtherST UPIN
223637010OtherACTIVE CARE
223637010OtherTRICARE
NJ0773794Medicaid
2236370100OtherBCBS TRADITIONAL
P2847360OtherOXFORD FREEDOM
223637010OtherACTIVE CARE
316706Medicare ID - Type Unspecified