Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 236454 | NY |
NPI | 1013189646 |
---|---|
Provider Name | Dr. Matthew John Freeby |
First Address | New York, NY 10032-3822 |
Second Address | New York, NY 10032-3822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2008 |
Last Update Date | 05/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02981533 | (05) | NY |
4X1261 | MEDICARE ID (01) | NY |