Peter Frederick, RDO
Individual provider Active NPI Optician · Rowley, MA
NPI 1548411960 · NPPES record last updated Jul 27, 2009
Key facts
- NPI
- 1548411960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- 1959 (MA)
- Practice address
- 144 Newburyport Tpke Ste A3
Rowley, MA 01969-2132 - Phone
- (978) 948-7756
- NPI assigned
- Oct 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 782 | NH | MD | Optician |
| 1959 | MA | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1959 | MA | Yes |
| Optician | 156FX1800X | 782 | NH |
Addresses
Primary practice location
144 Newburyport Tpke Ste A3
Rowley, MA 01969-2132
Mailing address
144 Newburyport Tpke Ste A3
Rowley, MA 01969-2132
Phone (978) 948-7756
Other providers in Rowley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.