Healthcare Provider Details

I. General information

NPI: 1083946966
Provider Name (Legal Business Name): MARTIN FREIMER M.D., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2010
Last Update Date: 06/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254B MOUNTAIN AVENUE SUITE 306
HACKETTSTOWN NJ
07840
US

IV. Provider business mailing address

254B MOUNTAIN AVENUE SUITE 306
HACKETTSTOWN NJ
07840
US

V. Phone/Fax

Practice location:
  • Phone: 908-684-0401
  • Fax: 908-684-1170
Mailing address:
  • Phone: 908-684-0401
  • Fax: 908-684-1170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA06078300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number25MA06078300
License Number StateNJ

VIII. Authorized Official

Name: MARTIN FREIMER
Title or Position: OWNER PHYSICIAN
Credential: M.D.
Phone: 908-684-0401