Provider Demographics
NPI:1902847411
Name:FREIRE, JORGE E (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:E
Last Name:FREIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JORGE
Other - Middle Name:EFRAIN
Other - Last Name:FREIRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 CAPITAL WAY
Mailing Address - Street 2:CAPITAL HEALTH MEDICAL CENTER AT HOPEWELL
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2520
Mailing Address - Country:US
Mailing Address - Phone:609-303-4244
Mailing Address - Fax:609-303-4156
Practice Address - Street 1:1 CAPITAL WAY
Practice Address - Street 2:CAPITAL HEALTH MEDICAL CENTER AT HOPEWELL
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2520
Practice Address - Country:US
Practice Address - Phone:609-303-4244
Practice Address - Fax:609-303-4156
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039543L2085R0001X
NJ25MA076728002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6438008Medicaid
PA001500970Medicaid
NJ6438008Medicaid
PA004924Medicare PIN
PAF58813Medicare UPIN