Provider Demographics
NPI:1467606988
Name:FREIFELD, BRUCE (MS,PT)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:
Last Name:FREIFELD
Suffix:
Gender:M
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5635 NETHERLAND AVE
Mailing Address - Street 2:APT. 4B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1739
Mailing Address - Country:US
Mailing Address - Phone:718-796-6588
Mailing Address - Fax:
Practice Address - Street 1:5635 NETHERLAND AVE
Practice Address - Street 2:APT. 4B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-1739
Practice Address - Country:US
Practice Address - Phone:718-796-6588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020586-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor