Healthcare Provider Details

I. General information

NPI: 1043671605
Provider Name (Legal Business Name): STEFANIE MORGAN FREETHEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEFANIE MORGAN WOZMAK

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

738 HOOKSETT RD
MANCHESTER NH
03104-2617
US

IV. Provider business mailing address

360 US HIGHWAY 1 BYP UNIT 102
PORTSMOUTH NH
03801-7105
US

V. Phone/Fax

Practice location:
  • Phone: 603-384-3900
  • Fax: 603-384-3912
Mailing address:
  • Phone: 603-410-6700
  • Fax: 603-319-8308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2020
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3541
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: