Fridovich, Mark A.

Fridovich, Mark A. is an sole proprietor health care provider with primary practice located at 14 Aulike St Ph 2, Kailua HI 96734-2740. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Fridovich, Mark A. can be contacted via phone (808) 236-8237.

Contact Information

Primary practice address
14 Aulike St Ph 2 Kailua HI 96734-2740
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2775 Massachusetts

Profile Details

NPI number 1629139837
LBN Legal business name Fridovich, Mark A.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629139837 NPPES
Massachusetts Other 2775 PSYCHOLOGIST

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