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General NPI Number Information
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NPI Number | 1558490235
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Entity Type | Individual
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Provider Name | MARK PATRICK FREITAS R.PH.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/31/2022
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Provider Practice Location Address
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Address Line | 32 W MAIN ST UNIT 2
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City | WASHINGTONVILLE
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State | NY
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Zip | 10992-1411
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Country | US
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Telephone | 845-496-8001
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Fax | 845-496-8005
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Provider Business Mailing Address
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Address Line | 32 W MAIN ST UNIT 2
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City | WASHINGTONVILLE
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State | NY
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Zip | 10992-1411
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Country | US
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Telephone | 845-496-8001
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Fax | 845-496-8005
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | R26118
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP041340R
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 039972
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License Number State | NY
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