Healthcare Provider Details

I. General information

NPI: 1689628570
Provider Name (Legal Business Name): BETH A FREIRE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820A TURNPIKE ST JEFFERSON OFFICE PARK
NORTH ANDOVER MA
01845-6124
US

IV. Provider business mailing address

800 TURNPIKE STREET JEFFERSON OFFICE PARK
NORTH ANDOVER MA
01845-6124
US

V. Phone/Fax

Practice location:
  • Phone: 978-557-5712
  • Fax: 978-557-5406
Mailing address:
  • Phone: 978-557-5712
  • Fax: 978-557-5406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number151359
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: