Provider Demographics
NPI:1174766091
Name:FREIH, WESAL Y (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WESAL
Middle Name:Y
Last Name:FREIH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:679 ROLLINGWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-1607
Mailing Address - Country:US
Mailing Address - Phone:914-494-1291
Mailing Address - Fax:
Practice Address - Street 1:679 ROLLINGWOOD WAY
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-1607
Practice Address - Country:US
Practice Address - Phone:914-494-1291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA0005X
NY261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1Medicaid
NY1Medicaid