Provider Demographics
NPI:1093812554
Name:FREED, SCHERZ, KLEINBERG, NUSSBAUM, FESTA, M.D. LLP
Entity Type:Organization
Organization Name:FREED, SCHERZ, KLEINBERG, NUSSBAUM, FESTA, M.D. LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:FREES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-588-4442
Mailing Address - Street 1:6144 ROUTE 25A
Mailing Address - Street 2:SUITE 23 & 24, BUILDING D
Mailing Address - City:WADING RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11792
Mailing Address - Country:US
Mailing Address - Phone:631-929-0400
Mailing Address - Fax:631-929-3382
Practice Address - Street 1:6144 ROUTE 25A
Practice Address - Street 2:SUITE 23 & 24, BUILDING D
Practice Address - City:WADING RIVER
Practice Address - State:NY
Practice Address - Zip Code:11792
Practice Address - Country:US
Practice Address - Phone:631-929-0400
Practice Address - Fax:631-929-3382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty