Healthcare Provider Details

I. General information

NPI: 1467460543
Provider Name (Legal Business Name): FREDDY ALMANZAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81-83 MANCHESTER AVE
PATERSON NJ
07502-1903
US

IV. Provider business mailing address

81-83 MANCHESTER AVE
PATERSON NJ
07502-1903
US

V. Phone/Fax

Practice location:
  • Phone: 973-942-9248
  • Fax: 973-790-0599
Mailing address:
  • Phone: 973-942-9248
  • Fax: 973-790-0599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number43ZA00300300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: