MEDICARE: STUART H FREEDENFELD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MA32327	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164498333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STUART H FREEDENFELD MD

Provider Business Mailing Address
First Line	:	56 S MAIN ST
Second Line	:	STE A
City	:	STOCKTON
State	:	NJ
Zip	:	08559
Country	:	US
Telephone Number	:	609-397-8585
Fax Number	:	609-397-1907

Provider Business Practice Location Address
First Line	:	56 S MAIN ST
Second Line	:	STE A
City	:	STOCKTON
State	:	NJ
Zip	:	08559
Country	:	US
Telephone Number	:	609-397-8585
Fax Number	:	609-397-1907

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	08/23/2010

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