Provider Demographics
NPI:1083946966
Name:MARTIN FREIMER M.D., PC
Entity Type:Organization
Organization Name:MARTIN FREIMER M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREIMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-684-0401
Mailing Address - Street 1:254B MOUNTAIN AVENUE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840
Mailing Address - Country:US
Mailing Address - Phone:908-684-0401
Mailing Address - Fax:908-684-1170
Practice Address - Street 1:254B MOUNTAIN AVENUE
Practice Address - Street 2:SUITE 306
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840
Practice Address - Country:US
Practice Address - Phone:908-684-0401
Practice Address - Fax:908-684-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA060783002084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ828784Medicare PIN
828784Medicare PIN