Healthcare Provider Details

I. General information

NPI: 1285873026
Provider Name (Legal Business Name): PETER C FREIS MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 02/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

443 MIDDLESEX AVE
METUCHEN NJ
08840-1422
US

IV. Provider business mailing address

443 MIDDLESEX AVE
METUCHEN NJ
08840-1422
US

V. Phone/Fax

Practice location:
  • Phone: 732-548-5991
  • Fax:
Mailing address:
  • Phone: 732-548-5991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberMA025379
License Number StateNJ

VIII. Authorized Official

Name: DR. PETER FREIS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 732-548-5991