Provider Demographics
NPI:1073831632
Name:STEPHEN F FREIFELD, MD,PA
Entity Type:Organization
Organization Name:STEPHEN F FREIFELD, MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:FREIFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-277-3875
Mailing Address - Street 1:454 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1158
Mailing Address - Country:US
Mailing Address - Phone:908-277-3875
Mailing Address - Fax:
Practice Address - Street 1:454 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1158
Practice Address - Country:US
Practice Address - Phone:908-277-3875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25-MA02187400174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2824400Medicaid
1881685352OtherNPI
FR427999OtherP10
1881685352OtherNPI