MEDICARE: PARTNERS IN FREEDOM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		NJ
2	207R00000X	Internal Medicine Physician		NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	DB7403	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5599107	OTHER	NJ	GHI
2	60004140	OTHER	NJ	HORIZON NJ HEALTH
3	2296455001	OTHER	NJ	AMERIHEALTH SEA GIRT LOCA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	2296455002	OTHER	NJ	AMERIHEALTH HOWELL LOCATI

General Provider Information

NPI Number	:	1114978939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARTNERS IN FREEDOM LLC

Provider Business Mailing Address
First Line	:	3350 HWY 138 STE 217
Second Line	:
City	:	WALL TOWNSHIP
State	:	NJ
Zip	:	07719-9694
Country	:	US
Telephone Number	:	732-974-1980
Fax Number	:	732-681-0835

Provider Business Practice Location Address
First Line	:	3350 HWY 138 STE 217
Second Line	:
City	:	WALL TOWNSHIP
State	:	NJ
Zip	:	07719-9694
Country	:	US
Telephone Number	:	732-974-1980
Fax Number	:	732-681-0835

Authorized Official
Title or Position	:	OFFICIAL DELEGATE/PRESIDENT
Name	:	DR. JANICE SICILIANO
Credential	:	DO
Telephone Number	:	732-974-1980

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	02/13/2023

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Directions to “PARTNERS IN FREEDOM LLC ” Practice Location

Language	Start Address	Practice Location

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