Andrea Frederic, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN751098 Issued in PA

Practice address

320 Avon St
Philadelphia, PA 19116-3208

Phone

(718) 340-8482

NPI assigned

Apr 20, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1205523255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 AVON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163208",
            "telephone_number": "718-340-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 AVON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163208",
            "telephone_number": "718-340-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERIC",
        "first_name": "ANDREA",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "PA",
            "license": "RN751098",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN751098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Frebel, PA-C
• Fred Tehrani MD LLC
• Jennifer Freda
• Lewis M. Fredane, MD
• Andrew Michael Freddo, MD, PHD
• Ted Marcel Frederic, DO
• Frederick S Lieberman MD PC
• James Robert Frederick, M.D.
• Christine M. Fredericks, P.T.
• Anne M Frederickson, MD

• Registered Nurse in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.