Individual
MARNI E FRIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
622 W 168 ST, NEW YORK, NY 10032
(646) 891-7813
Mailing address
1156 N BROADWAY, YONKERS, NY 10701-1108
(914) 965-3700
(914) 965-3883
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
020192
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00355940
AGENCY MEDICAID #
NY
01
—
1285628552
AGENCY NPI #
NY
01
—
WVE061
AGENCY MEDICARE ID
NY
Enumeration date
08/22/2011
Last updated
11/12/2024
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