Provider Demographics
NPI:1982014577
Name:FRIEDMAN, HENRIETTA LI (OTR/L)
Entity type:Individual
Prefix:
First Name:HENRIETTA
Middle Name:LI
Last Name:FRIEDMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1671 SUMMERFIELD STREET
Mailing Address - Street 2:PHD
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-0952
Mailing Address - Country:US
Mailing Address - Phone:718-887-1198
Mailing Address - Fax:
Practice Address - Street 1:220 E 42ND ST FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5832
Practice Address - Country:US
Practice Address - Phone:718-887-1198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NY63 018854225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist