Healthcare Provider Details

I. General information

NPI: 1275454951
Provider Name (Legal Business Name): ESSENCE AMOUR FREELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 KINGS HIGHWAY, BROOKLYN, NY 11229
NEW YORK NY
11229
US

IV. Provider business mailing address

1623 KINGS HIGHWAY, BROOKLYN, NY 11229
NEW YORK NY
11229
US

V. Phone/Fax

Practice location:
  • Phone: 929-636-5917
  • Fax:
Mailing address:
  • Phone: 929-636-5917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberZERO
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: