Bruce David Friedin, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6955 Issued in NY

Practice address

39 New Mill Rd
Smithtown, NY 11787-3323

Phone

(631) 361-6910

Fax

(631) 361-6910

NPI assigned

Dec 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811065451",
    "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": "631-361-6910",
            "fax_number": "631-361-6910"
        },
        {
            "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": "631-361-6910",
            "fax_number": "631-361-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDIN",
        "first_name": "BRUCE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "6955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John L Franco, M.D.
• Shericka Sherrelle Franks, LPN
• Diane E. Freedman, RLCSW
• Elissa Frein
• Robbin Friedberg
• Jillian Veronica Friedin, PSY.D.
• Steven P Friedling, MD
• Rani B Fritz, DO
• Lauren Elizabeth Fromberg, MSPED
• Renee Fumento

• Clinical Psychologist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.