Provider Demographics
NPI:1275884041
Name:FREEMAN, CHANA (MS)
Entity Type:Individual
Prefix:
First Name:CHANA
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 STERLING ST
Mailing Address - Street 2:2F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4404
Mailing Address - Country:US
Mailing Address - Phone:718-221-2915
Mailing Address - Fax:
Practice Address - Street 1:430 STERLING ST
Practice Address - Street 2:2F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-4404
Practice Address - Country:US
Practice Address - Phone:718-221-2915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist