Provider Demographics
NPI:1295892644
Name:NOAH D FREEDMAN MD PC
Entity type:Organization
Organization Name:NOAH D FREEDMAN MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAHN-FREEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:718-598-3454
Mailing Address - Street 1:8300 TALBOT ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3516
Mailing Address - Country:US
Mailing Address - Phone:718-598-3454
Mailing Address - Fax:505-930-5398
Practice Address - Street 1:8300 TALBOT ST APT 2B
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-3516
Practice Address - Country:US
Practice Address - Phone:718-440-7867
Practice Address - Fax:505-930-5398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0800X
PAMD048098L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF45962Medicare UPIN
PA056320Medicare PIN