MEDICARE: GILL L FREI 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	207R00000X	Internal Medicine Physician	168619	NY
2	207RN0300X	Nephrology Physician	168619	NY

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	:	1477541761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILL L FREI MD

Provider Business Mailing Address
First Line	:	2452 BRONX PARK E
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-7503
Country	:	US
Telephone Number	:	718-655-4956
Fax Number	:	718-652-8058

Provider Business Practice Location Address
First Line	:	1200 WATERS PL
Second Line	:	SUITE M104
City	:	BRONX
State	:	NY
Zip	:	10461-2728
Country	:	US
Telephone Number	:	718-794-1200
Fax Number	:

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	05/26/2016

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Directions to “ GILL L FREI MD” Practice Location

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