Provider Demographics
NPI:1790822484
Name:DR. FREED & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:DR. FREED & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:FREED
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:952-401-1787
Mailing Address - Street 1:4004 HALLGREN CT
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-7755
Mailing Address - Country:US
Mailing Address - Phone:952-401-1787
Mailing Address - Fax:
Practice Address - Street 1:900 NICOLLET MALL
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2530
Practice Address - Country:US
Practice Address - Phone:612-338-7551
Practice Address - Fax:612-338-7403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2626152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU68764Medicare UPIN