Healthcare Provider Details

I. General information

NPI: 1225243314
Provider Name (Legal Business Name): DONNA ALMARIA FREEMAN-TWEED RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BROOKLYN COLLEGE HEALTH CLINIC 2900 BEDFORD AV, ROOM 114 ROOOSEVELT HALL
BROOKLYN NY
11210
US

IV. Provider business mailing address

821A UNION ST APT #3
BROOKLYN NY
11215-1337
US

V. Phone/Fax

Practice location:
  • Phone: 718-951-5580
  • Fax: 718-951-5869
Mailing address:
  • Phone: 718-789-9856
  • Fax: 718-951-5869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberNYS006805
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: