Healthcare Provider Details

I. General information

NPI: 1922628817
Provider Name (Legal Business Name): CHARLES J FREEBURG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SEARS DR STE 202
PARAMUS NJ
07652-3539
US

IV. Provider business mailing address

2 SEARS DR STE 202
PARAMUS NJ
07652-3539
US

V. Phone/Fax

Practice location:
  • Phone: 201-343-3433
  • Fax:
Mailing address:
  • Phone: 201-343-3433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberCHFREEBURG
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: