Healthcare Provider Details

I. General information

NPI: 1083532790
Provider Name (Legal Business Name): DONNA ROSE FREED DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 GREENFIELD RD
SYOSSET NY
11791-4800
US

IV. Provider business mailing address

1063 HIGHLAND ST
BALDWIN NY
11510-3623
US

V. Phone/Fax

Practice location:
  • Phone: 516-628-5910
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number360371
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: