MEDICARE: DR. GERARD MARTIN FREISINGER M.D.

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	207RC0000X	Cardiovascular Disease Physician	105585	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285623520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERARD MARTIN FREISINGER M.D.

Provider Business Mailing Address
First Line	:	20 GRAND ST
Second Line	:	3RD FLOOR
City	:	WARWICK
State	:	NY
Zip	:	10990-1035
Country	:	US
Telephone Number	:	845-987-3973
Fax Number	:	845-987-5979

Provider Business Practice Location Address
First Line	:	15 MAPLE AVENUE
Second Line	:
City	:	WARWICK
State	:	NY
Zip	:	10990-1522
Country	:	US
Telephone Number	:	845-987-5147
Fax Number	:	845-986-1803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	01/29/2010

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