Healthcare Provider Details

I. General information

NPI: 1184676934
Provider Name (Legal Business Name): BORIS FREYMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PANTHER VALLEY MALL, BLDG B, ROUTE 517
HACKETTSTOWN NJ
07840
US

IV. Provider business mailing address

PANTHER VALLEY MALL, BLDG B, ROUTE 517
HACKETTSTOWN NJ
07840
US

V. Phone/Fax

Practice location:
  • Phone: 908-362-8866
  • Fax: 908-850-9160
Mailing address:
  • Phone: 908-362-8866
  • Fax: 908-850-9160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMB072502
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: