Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 170165 | NY |
N | 111NI0900X | Internist | 170165 | NY |
Y | 207RR0500X | Rheumatology | 170165 | NY |
NPI | 1104862986 |
---|---|
Provider Name | Dr. James G. Freeman |
First Address | Elmira, NY 14901-3230 |
Second Address | Elmira, NY 14901-3218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 10/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01031736 | (05) | NY |