MEDICARE: NEPHROLOGY & HYPERTENSION ASSOCIATES, PC

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	207RN0300X	Nephrology Physician		NY

General Provider Information

NPI Number	:	1700858636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEPHROLOGY & HYPERTENSION ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	1200 WATERS PL
Second Line	:	SUITE M104
City	:	BRONX
State	:	NY
Zip	:	10461-2728
Country	:	US
Telephone Number	:	718-794-1200
Fax Number	:	718-794-1222

Provider Business Practice Location Address
First Line	:	1200 WATERS PL
Second Line	:	SUITE M104
City	:	BRONX
State	:	NY
Zip	:	10461-2728
Country	:	US
Telephone Number	:	718-794-1200
Fax Number	:	718-794-1222

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GILL LEOR FREI
Credential	:	MD
Telephone Number	:	718-794-1200

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	07/21/2022

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