Provider Demographics
NPI:1568413615
Name:FREED, HAL MARC (AUD)
Entity Type:Individual
Prefix:DR
First Name:HAL
Middle Name:MARC
Last Name:FREED
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2866 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5726
Mailing Address - Country:US
Mailing Address - Phone:516-221-2390
Mailing Address - Fax:516-221-2395
Practice Address - Street 1:3244 FRANCIS LEWIS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1925
Practice Address - Country:US
Practice Address - Phone:718-460-3100
Practice Address - Fax:718-939-0248
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000003127237600000X
NY0001358231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2C9420OtherHEALTHNET
NYP2625570OtherOXFORD
NYS39630Medicare UPIN
NYM90011Medicare UPIN
NYP2625570OtherOXFORD