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General NPI Number Information
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NPI Number | 1164438057
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Entity Type | Individual
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Provider Name | ELAINE M. FREILER M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 325 PARK AVE
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City | HUNTINGTON
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State | NY
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Zip | 11743-2779
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Country | US
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Telephone | 631-351-3744
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Fax | 631-351-6175
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Provider Business Mailing Address
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Address Line | 325 PARK AVE
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City | HUNTINGTON
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State | NY
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Zip | 11743-2779
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Country | US
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Telephone | 631-351-3744
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Fax | 631-351-6175
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 153855-2
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License Number State | NY
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