MEDICARE: DR. PAUL MAX FREUDMAN 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	207L00000X	Anesthesiology Physician	162541-1	NY
2	207L00000X	Anesthesiology Physician	25MA04668800	NJ
3	207L00000X	Anesthesiology Physician		IL

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	:	1952453102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL MAX FREUDMAN M.D.

Provider Business Mailing Address
First Line	:	5 POND PARK RD
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11023-2011
Country	:	US
Telephone Number	:	516-384-0777
Fax Number	:

Provider Business Practice Location Address
First Line	:	38 W 32ND ST
Second Line	:	SUITE 1200
City	:	NEW YORK
State	:	NY
Zip	:	10001-3816
Country	:	US
Telephone Number	:	800-673-5766
Fax Number	:

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/08/2007

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