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Individual

DR. BRYAN MICHAEL FREILICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
111 E 210TH ST, KLAU 2, BRONX, NY 10467-2401
(718) 653-4859
Mailing address
51 SYCAMORE LN, LEVITTOWN, NY 11756-3037
(718) 825-5911

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
016759
NY
103TC0700X
Clinical Psychologist
016759-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02793319
NY
Enumeration date
06/09/2006
Last updated
12/13/2013
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