Provider Demographics
NPI:1407273154
Name:FREUND, LEEBA
Entity Type:Individual
Prefix:
First Name:LEEBA
Middle Name:
Last Name:FREUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3914 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4410
Mailing Address - Country:US
Mailing Address - Phone:718-853-9700
Mailing Address - Fax:718-853-5533
Practice Address - Street 1:3914 15TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4410
Practice Address - Country:US
Practice Address - Phone:718-853-9700
Practice Address - Fax:718-853-5533
Is Sole Proprietor?:No
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator