Provider Demographics
NPI:1023285343
Name:FREITAS, MARILEE L (MD)
Entity type:Individual
Prefix:
First Name:MARILEE
Middle Name:L
Last Name:FREITAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 HOSPITAL PLAZA
Mailing Address - Street 2:SUITE 604
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3602
Mailing Address - Country:US
Mailing Address - Phone:203-323-8989
Mailing Address - Fax:203-975-9904
Practice Address - Street 1:29 HOSPITAL PLAZA
Practice Address - Street 2:SUITE 604
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3602
Practice Address - Country:US
Practice Address - Phone:203-323-8989
Practice Address - Fax:203-975-9904
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT046545208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery