Healthcare Provider Details

I. General information

NPI: 1477623809
Provider Name (Legal Business Name): RICHARD G FREEMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 WESTCHESTER AVE STE 101
WHITE PLAINS NY
10604
US

IV. Provider business mailing address

222 WESTCHESTER AVE STE 101
WHITE PLAINS NY
10604
US

V. Phone/Fax

Practice location:
  • Phone: 914-946-1010
  • Fax: 914-946-1025
Mailing address:
  • Phone: 914-946-1010
  • Fax: 914-946-1025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number087622
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: