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General NPI Number Information
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NPI Number | 1427005974
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Entity Type | Individual
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Provider Name | MICHAEL E. FRESHMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 1444 MASSACHUSETTS AVE SUITE 104
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City | TROY
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State | NY
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Zip | 12180-1600
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Country | US
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Telephone | 518-274-5551
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Fax | 518-274-2060
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Provider Business Mailing Address
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Address Line | 13 RUSO DR
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City | MENANDS
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State | NY
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Zip | 12204-1313
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Country | US
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Telephone | 518-449-1738
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 094749
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License Number State | NY
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