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General NPI Number Information
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NPI Number | 1154308211
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Entity Type | Individual
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Provider Name | ELIZABETH S FREEDMAN MD
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Gender | Female
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 08/06/2013
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Provider Practice Location Address
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Address Line | 13 CHURCH RD
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City | EAST GRANBY
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State | CT
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Zip | 06026-0518
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Country | US
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Telephone | 860-653-4526
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Fax | 860-653-5307
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Provider Business Mailing Address
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Address Line | 13 CHURCH RD PO BOX 518
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City | EAST GRANBY
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State | CT
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Zip | 06026-0518
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Country | US
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Telephone | 860-653-4526
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Fax | 860-653-5209
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 037507
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License Number State | CT
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