Provider Demographics
NPI:1912868993
Name:FREIRE, MARCELA
Entity type:Individual
Prefix:
First Name:MARCELA
Middle Name:
Last Name:FREIRE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22757 113TH DR
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-2722
Mailing Address - Country:US
Mailing Address - Phone:718-568-9108
Mailing Address - Fax:
Practice Address - Street 1:22757 113TH DR
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-2722
Practice Address - Country:US
Practice Address - Phone:718-568-9108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator