Individual
DR. ELISSA LANE FREEDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 LIBERTY DR, SUITE A, HEBRON, CT 06248-1553
(860) 228-1119
(860) 228-4314
Mailing address
23 LIBERTY DR, SUITE A, HEBRON, CT 06248-1553
(860) 228-1119
(860) 228-4314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
050034
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236164
—
CT
01
—
1013197722
NPI
—
Enumeration date
11/09/2007
Last updated
06/12/2013
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