Healthcare Provider Details

I. General information

NPI: 1891924171
Provider Name (Legal Business Name): ESTHER E FREEMAN M.D., PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 03/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 STANIFORD ST SUITE 200
BOSTON MA
02114-2517
US

IV. Provider business mailing address

50 STANIFORD ST SUITE 200
BOSTON MA
02114-2517
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-2914
  • Fax:
Mailing address:
  • Phone: 617-726-2914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NI0002X
TaxonomyClinical & Laboratory Dermatological Immunology Physician
License NumberLL240841
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: