Individual provider Active NPI

Marylouis Friedberger, PA-C

  • Physician Assistant
  • Phila, PA
National Provider Identifier
1962468009
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA000388L Issued in PA
Practice address
University & Woodland Ave
Phila VA Med Center
Phila, PA 19104
Phone
(215) 823-4300
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA000388L PA Primary

Addresses

Primary practice location

University & Woodland Ave
Phila VA Med Center
Phila, PA 19104

Mailing address

617 W Naomi St
Phila, PA 19144-3710
Phone (215) 843-9909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA000388LPAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962468009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 W NAOMI ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191443710",
            "telephone_number": "215-843-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY & WOODLAND AVE",
            "address_2": "PHILA VA MED CENTER",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-823-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDBERGER",
        "first_name": "MARYLOUIS",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA000388L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.