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General NPI Number Information
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NPI Number | 1396724415
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Entity Type | Individual
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Provider Name | JENNY E FREEMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 411 WAVERLY OAKS RD #150
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City | WALTHAM
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State | MA
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Zip | 02452-8448
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Country | US
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Telephone | 781-373-1636
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Fax | 781-373-1653
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Provider Business Mailing Address
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Address Line | 59 ASH ST
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City | WESTON
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State | MA
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Zip | 02493-1927
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Country | US
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Telephone | 781-760-5569
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 152076
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 152076
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License Number State | MA
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