Provider Demographics
NPI:1548401110
Name:FREEDMAN, DENISE MARI (PT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:MARI
Last Name:FREEDMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 WOODSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-3235
Mailing Address - Country:US
Mailing Address - Phone:716-775-6787
Mailing Address - Fax:
Practice Address - Street 1:186 WOODSTREAM DR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-3235
Practice Address - Country:US
Practice Address - Phone:716-775-6787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009532-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist