Provider Demographics
NPI:1700086352
Name:ROBERT A. FREEDMAN, M.D. P.C
Entity Type:Organization
Organization Name:ROBERT A. FREEDMAN, M.D. P.C
Other - Org Name:EYE CENTER OF NORTH SHORE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:FREEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-744-1177
Mailing Address - Street 1:400 HIGHLAND AVE
Mailing Address - Street 2:SUITE 20
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-7003
Mailing Address - Country:US
Mailing Address - Phone:978-744-1177
Mailing Address - Fax:978-910-0125
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970
Practice Address - Country:UM
Practice Address - Phone:978-744-1177
Practice Address - Fax:978-910-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37309207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1598878738OtherINDIVIDUAL NPI