Provider Demographics
NPI:1154507770
Name:FREEMAN, ERIC C (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:C
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 169
Mailing Address - Street 2:145 ORINOCO DROVE
Mailing Address - City:BRIGHTWATERS
Mailing Address - State:NY
Mailing Address - Zip Code:11718-2509
Mailing Address - Country:US
Mailing Address - Phone:617-645-9953
Mailing Address - Fax:
Practice Address - Street 1:145 ORINOCO DR
Practice Address - Street 2:
Practice Address - City:BRIGHTWATERS
Practice Address - State:NY
Practice Address - Zip Code:11718-3024
Practice Address - Country:US
Practice Address - Phone:617-645-9953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60203136207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology