Provider Demographics
NPI:1801588751
Name:FREEMAN, MOIRA SMALLEY
Entity type:Individual
Prefix:
First Name:MOIRA
Middle Name:SMALLEY
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 SEEKONK ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1173
Mailing Address - Country:US
Mailing Address - Phone:443-465-2971
Mailing Address - Fax:
Practice Address - Street 1:7 BISHOP ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8323
Practice Address - Country:US
Practice Address - Phone:508-879-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program