Provider Demographics
NPI:1457643942
Name:JEFFREY S. FREED, MD,PC
Entity Type:Organization
Organization Name:JEFFREY S. FREED, MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:FREED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-396-0050
Mailing Address - Street 1:969 PARK AVE
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0322
Mailing Address - Country:US
Mailing Address - Phone:212-396-0050
Mailing Address - Fax:212-396-0052
Practice Address - Street 1:969 PARK AVE
Practice Address - Street 2:SUITE 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0322
Practice Address - Country:US
Practice Address - Phone:212-396-0050
Practice Address - Fax:212-396-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty