Nicole Marie Frederick, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

006331 Issued in NY

Practice address

139 Fulton St RM 208
New York, NY 10038-2538

Phone

(212) 513-0437

NPI assigned

Sep 5, 2018

Sex

Female

Sole proprietor

No

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": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1457833527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 FULTON ST RM 208",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382538",
            "telephone_number": "212-513-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 FULTON ST RM 208",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382538",
            "telephone_number": "212-513-0437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Downing St Apt A",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100144779",
            "country_code": "US",
            "telephone_number": "917-804-3585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "006331",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "6331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hazel Beverly Frederick-McMillan
• Aquilla Frederick, M.B.A., L.M.S.W.
• Gladys Frederick
• Jeremy J Frederick, MD
• Mary Margaret Frederick, PH.D.
• Shauna Louise Cynthia Frederick, LMSW
• Tamara Frederick, CASAC
• John M Fredericks Jr., LPN
• Nadia N Fredericks, RD
• Samuel Fredericks

• Acupuncturist in New York, NY
• Providers in New York, NY by specialty
• Acupuncturist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.