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Individual

BEAU FROEBEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2 FARM COLONY DR, WARREN, PA 16365-5203
(716) 484-6700
(716) 487-0166
Mailing address
989 SUMNER RD, DARIEN CENTER, NY 14040-9711

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD472023
PA
390200000X
Student in an Organized Health Care Education/Training Program
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06362867
NY
05
103854010
PA
Enumeration date
03/23/2017
Last updated
09/28/2021
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