Provider Demographics
NPI:1689705188
Name:FREEDMAN, HERBERT N (MD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:N
Last Name:FREEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 LEXINGTON AVE
Mailing Address - Street 2:STE 256
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5055
Mailing Address - Country:US
Mailing Address - Phone:212-517-1001
Mailing Address - Fax:516-295-4727
Practice Address - Street 1:133 E. 73 ST.
Practice Address - Street 2:STE 501
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-517-1001
Practice Address - Fax:516-295-4727
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102255207W00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY702641Medicare ID - Type Unspecified
NYC 11991Medicare UPIN