Provider Demographics
NPI:1811132491
Name:FREELEY, CHRISTINE M (RPH)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:FREELEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3065
Mailing Address - Country:US
Mailing Address - Phone:585-697-6071
Mailing Address - Fax:585-336-1750
Practice Address - Street 1:1500 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3065
Practice Address - Country:US
Practice Address - Phone:585-697-6071
Practice Address - Fax:585-336-1750
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY039777OtherPHARMACIST LICENSE