MEDICARE: DR. KENNETH JAY FREEDMAN DC

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	111N00000X	Chiropractor	01680	NJ

General Provider Information

NPI Number	:	1568436848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH JAY FREEDMAN DC

Provider Business Mailing Address
First Line	:	BRIER HILL COURT
Second Line	:	D6
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-3335
Country	:	US
Telephone Number	:	732-254-6011
Fax Number	:	732-254-7271

Provider Business Practice Location Address
First Line	:	BRIER HILL COURT
Second Line	:	D6
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-3335
Country	:	US
Telephone Number	:	732-254-6011
Fax Number	:	732-254-7271

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

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	07/08/2007

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