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General NPI Number Information
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NPI Number | 1285618850
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Entity Type | Individual
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Provider Name | NATHAN FREED DO
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Gender | Male
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 2301 E ALLEGHENY AVE MADEL PAVILION 1ST FL
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City | PHILA
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State | PA
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Zip | 19134-4427
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Country | US
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Telephone | 215-936-3880
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Fax | 215-926-3888
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Provider Business Mailing Address
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Address Line | 2301 E ALLEGHENY AVE 1ST FLOOR
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City | PHILA
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State | PA
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Zip | 19134-4427
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Country | US
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Telephone | 215-926-9022
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Fax | 215-926-3888
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | OS006031E
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License Number State | PA
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