1245207828 NPI number — ARNOLD S FREEDMAN MD

Table of content: ARNOLD S FREEDMAN MD (NPI 1245207828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245207828 NPI number — ARNOLD S FREEDMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FREEDMAN
Provider First Name:
ARNOLD
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245207828
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1065 WALNUT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02461-1262
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-969-2934
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 BINNEY STREET
Provider Second Line Business Practice Location Address:
ROOM D1B30 DFCI DANA FARBER CANCER INSTITUTE
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-632-4894
Provider Business Practice Location Address Fax Number:
617-582-7890
Provider Enumeration Date:
03/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RX0202X , with the licence number:  47330 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0149772 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6463723 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3000067 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2062907 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: C05313 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 735023 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: B97225DF . This is a "HPHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 43622 . This is a "FALLON COMMUNITY HEALTH P" identifier . This identifiers is of the category "OTHER".




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