Individual provider Active NPI

Jillian Veronica Friedin, PSY.D.

  • Clinical Psychologist
  • Smithtown, NY
National Provider Identifier
1346578960
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
018281 Issued in NY
Practice address
39 New Mill Rd
Smithtown, NY 11787-3323
Phone
(631) 332-7237
NPI assigned
Nov 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 018281 NY Primary

Addresses

Primary practice location

39 New Mill Rd
Smithtown, NY 11787-3323

Mailing address

39 New Mill Rd
Smithtown, NY 11787-3323
Phone (631) 332-7237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
018281NYMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1346578960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 NEW MILL RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873323",
            "telephone_number": "631-332-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 NEW MILL RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873323",
            "telephone_number": "631-332-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDIN",
        "first_name": "JILLIAN",
        "middle_name": "VERONICA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.