Provider Demographics
NPI:1467460543
Name:ALMANZAR, FREDDY
Entity Type:Individual
Prefix:
First Name:FREDDY
Middle Name:
Last Name:ALMANZAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81-83 MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-1903
Mailing Address - Country:US
Mailing Address - Phone:973-942-9248
Mailing Address - Fax:973-790-0599
Practice Address - Street 1:81-83 MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07502-1903
Practice Address - Country:US
Practice Address - Phone:973-942-9248
Practice Address - Fax:973-790-0599
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43ZA003003002278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6419801Medicaid
NJ6419801Medicaid
NJ310258Medicare ID - Type Unspecified