Healthcare Provider Details

I. General information

NPI: 1265755235
Provider Name (Legal Business Name): HEATHER FREILICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2010
Last Update Date: 03/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 LEE BLVD
YORKTOWN HEIGHTS NY
10598-1100
US

IV. Provider business mailing address

650 LEE BLVD
YORKTOWN HEIGHTS NY
10598-1100
US

V. Phone/Fax

Practice location:
  • Phone: 914-245-8111
  • Fax:
Mailing address:
  • Phone: 914-245-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number007206
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: