Organization
FOREBRAIN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN FRIED PHD (SUPERVISING PSYCHOLOGIST)
(917) 922-1751
Entity
Organization
Contact information
Practice address
7917 18TH AVE, BROOKLYN, NY 11214-1703
(917) 922-1751
Mailing address
58 CHARLES ST, NEW YORK, NY 10014-2750
(212) 620-0488
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
011416
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02742978
—
NY
Enumeration date
05/17/2006
Last updated
08/22/2020
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