Provider Demographics
NPI:1538103262
Name:FREEDMAN, HOWARD GARY (DC)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:GARY
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5045 ROUTE 38
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-4801
Mailing Address - Country:US
Mailing Address - Phone:856-663-4414
Mailing Address - Fax:856-486-9064
Practice Address - Street 1:6650 BROWNING ROAD
Practice Address - Street 2:U12
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-1479
Practice Address - Country:US
Practice Address - Phone:856-663-4414
Practice Address - Fax:856-486-9064
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00286500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT73011Medicare UPIN
NJ476649Medicare ID - Type Unspecified