Provider Demographics
NPI:1396917704
Name:SUSAN FREIMAN CDN
Entity type:Organization
Organization Name:SUSAN FREIMAN CDN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:FREIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NUTRITIONIST/CHIROPR
Authorized Official - Phone:516-487-5033
Mailing Address - Street 1:8 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1921
Mailing Address - Country:US
Mailing Address - Phone:516-487-5033
Mailing Address - Fax:516-487-5033
Practice Address - Street 1:8 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1921
Practice Address - Country:US
Practice Address - Phone:516-487-5033
Practice Address - Fax:516-487-5033
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUSAN FREIMAN CDN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4382-1133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty