Healthcare Provider Details

I. General information

NPI: 1598961815
Provider Name (Legal Business Name): HELENE LINDA FREER DPM,MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 GRIMM RD
NEWBURGH NY
12550-2813
US

IV. Provider business mailing address

8 GRIMM RD
NEWBURGH NY
12550-2813
US

V. Phone/Fax

Practice location:
  • Phone: 845-561-7787
  • Fax:
Mailing address:
  • Phone: 845-561-7787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberNY003405
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: