Provider Demographics
NPI:1366417669
Name:FREEDMAN, NOAH DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:NOAH
Middle Name:DAVID
Last Name:FREEDMAN
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 1:8300 TALBOT ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3516
Mailing Address - Country:US
Mailing Address - Phone:718-440-7867
Mailing Address - Fax:505-930-5398
Practice Address - Street 1:8300 TALBOT ST APT 2B
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-3516
Practice Address - Country:US
Practice Address - Phone:718-440-7867
Practice Address - Fax:505-930-5398
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325477-012084P0800X
NMMD2016-02722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM97572861Medicaid
PA433322QE2Medicare PIN
NM520579YMWNMedicare PIN
NM97572861Medicaid