Provider Demographics
NPI:1326073875
Name:FREE, RICHARD GREGORY (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:GREGORY
Last Name:FREE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-5727
Mailing Address - Country:US
Mailing Address - Phone:203-261-6111
Mailing Address - Fax:203-261-9238
Practice Address - Street 1:900 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-5727
Practice Address - Country:US
Practice Address - Phone:203-261-6111
Practice Address - Fax:203-261-9238
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031154207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E89924Medicare UPIN