Healthcare Provider Details

I. General information

NPI: 1801989058
Provider Name (Legal Business Name): ORLANDO FREYRE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 05/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5616 6TH AVE
BROOKLYN NY
11220-3419
US

IV. Provider business mailing address

5616 6TH AVENUE
BROOKLYN NY
11220
US

V. Phone/Fax

Practice location:
  • Phone: 718-439-5440
  • Fax:
Mailing address:
  • Phone: 718-439-5440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number206642
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: