Provider Demographics
NPI:1295783611
Name:FREILICH, DAVID ERIC (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ERIC
Last Name:FREILICH
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 1:14 EAST 96TH STREET
Mailing Address - Street 2:SUITE 01
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0781
Mailing Address - Country:US
Mailing Address - Phone:212-410-5000
Mailing Address - Fax:212-722-0503
Practice Address - Street 1:15 ENGLE ST STE 106
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2920
Practice Address - Country:US
Practice Address - Phone:201-871-8900
Practice Address - Fax:201-871-2323
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212284207W00000X, 207WX0200X
NJ25MA07555900207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H44847Medicare UPIN
NY450B31Medicare ID - Type Unspecified