MEDICARE: STUART H FREEDENFELD

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

General Provider Information

NPI Number	:	1568436517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STUART H FREEDENFELD

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	:	MEDICAL DIRECTOR
Name	:	STUART H FREEDENFELD
Credential	:	MD
Telephone Number	:	609-397-8585

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	08/23/2010

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