Provider Demographics
NPI:1043334170
Name:FREEDMAN, MARILYN (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BOND ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2448
Mailing Address - Country:US
Mailing Address - Phone:516-829-0960
Mailing Address - Fax:516-684-9746
Practice Address - Street 1:8 BOND ST
Practice Address - Street 2:SUITE 202
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2448
Practice Address - Country:US
Practice Address - Phone:516-829-0960
Practice Address - Fax:516-684-9746
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6288-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN21842OtherGUARDIAN-HEALTH NET
NY806925OtherMPN-UHC EMPIRE PLAN
NY0896498OtherAETNA HEALTHCARE
NYP915260OtherOXFORD INSURANCE