Healthcare Provider Details

I. General information

NPI: 1699687277
Provider Name (Legal Business Name): HASAD FREITAG PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 ELMWOOD AVE
ROCHESTER NY
14620-3005
US

IV. Provider business mailing address

86 S UNION ST APT 203
ROCHESTER NY
14607-1853
US

V. Phone/Fax

Practice location:
  • Phone: 585-241-1200
  • Fax: 585-241-1424
Mailing address:
  • Phone: 415-760-3917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number028425
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: