Provider Demographics
NPI:1306817515
Name:FREEMAN, ERIC L (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:L
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2320
Mailing Address - Country:US
Mailing Address - Phone:516-295-0111
Mailing Address - Fax:
Practice Address - Street 1:657 CENTRAL AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516
Practice Address - Country:US
Practice Address - Phone:516-295-0111
Practice Address - Fax:516-295-9438
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203136207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G98093Medicare UPIN
NY87G221Medicare ID - Type Unspecified