Healthcare Provider Details

I. General information

NPI: 1942434204
Provider Name (Legal Business Name): FREEHOLD OBSERVATIONALIST PHYSICIANS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2009
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 WEST MAIN STREET
FREEHOLD NJ
07728
US

IV. Provider business mailing address

PO BOX 512
HOWELL NJ
07731-0512
US

V. Phone/Fax

Practice location:
  • Phone: 732-294-7012
  • Fax:
Mailing address:
  • Phone: 732-294-7012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HOWARD STEIN
Title or Position: PRESIDENT
Credential: DO
Phone: 732-294-7012