Provider Demographics
NPI:1831671635
Name:FREEMAN, ENA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ENA
Middle Name:
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 CENTRAL PARK W APT 14B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-0019
Mailing Address - Country:US
Mailing Address - Phone:212-316-4485
Mailing Address - Fax:212-316-4630
Practice Address - Street 1:350 CENTRAL PARK W APT 14B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-0019
Practice Address - Country:US
Practice Address - Phone:212-316-4485
Practice Address - Fax:212-316-4630
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004225235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist