Provider Demographics
NPI:1356400014
Name:TED L. FREEMAN,DO, PC
Entity type:Organization
Organization Name:TED L. FREEMAN,DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:L
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-785-1600
Mailing Address - Street 1:186 JACK MARTIN BLVD
Mailing Address - Street 2:SUITE B1
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7728
Mailing Address - Country:US
Mailing Address - Phone:732-785-1600
Mailing Address - Fax:732-785-1642
Practice Address - Street 1:186 JACK MARTIN BLVD
Practice Address - Street 2:SUITE B1
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7728
Practice Address - Country:US
Practice Address - Phone:732-785-1600
Practice Address - Fax:732-785-1642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06110000208VP0014X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty