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DR. ELISSA LANE FREEDMAN

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1013197722

Individual Registrant:
DR. ELISSA LANE FREEDMAN 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
23 LIBERTY DR SUITE A HEBRON, CT 06248-1553 US
Tel: 860-228-1119  Fax: 860-228-4314

Contact information for business:
23 LIBERTY DR SUITE A HEBRON, CT 06248-1553 US
Tel: 860-228-1119  Fax: 860-228-4314

Registration Information:
NPI: 1013197722
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
CT050034

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
NPI101319772201
004236164CT05




HEALTH CARE JOBS CT - Page 1



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