Provider Demographics
NPI:1619161601
Name:FREUND, WILLIAM H
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:FREUND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:HENRY
Other - Last Name:FREUND
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:OPHTHALMIC DISPENSER
Mailing Address - Street 1:71 CENTRAL SQ
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-2167
Mailing Address - Country:US
Mailing Address - Phone:609-927-0990
Mailing Address - Fax:
Practice Address - Street 1:71 CENTRAL SQ
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-2167
Practice Address - Country:US
Practice Address - Phone:609-927-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-01
Last Update Date:2007-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00077300156FC0800X, 156FX1700X
NJ31 TD00077300156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens
No156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0126365Medicaid
0606770001Medicare NSC