Nicole Staci Fridas, TSHH, MSED, PD - SAS

Primary specialty

SpecialistTaxonomy code 174400000X

License

13637062 Issued in NY

Practice address

33 Walt Whitman Rd
Ste 300B
Huntington Station, NY 11746-3640

Phone

(631) 385-7780

NPI assigned

Jan 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1629115274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SADDLER CT",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117464200",
            "telephone_number": "631-805-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WALT WHITMAN RD",
            "address_2": "STE 300B",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117463640",
            "telephone_number": "631-385-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDAS",
        "first_name": "NICOLE",
        "middle_name": "STACI",
        "name_prefix": "Ms.",
        "credential": "TSHH, MSED, PD - SAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "33807061",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "13637062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindy Fortgang, MSED
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• Elisa Kay Freire-Davis, OTR
• Marsha Stacy Fried, O.D.
• Neil Fruchtman
• Paul J Fuccillo, L.AC. LMT MS MA
• Alan R Furman, DC
• G Burbano

• Specialist in Huntington Station, NY
• Providers in Huntington Station, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.