SUSAN ELIZABETH FREDERICKS


Address: 1 Crescent Drive Suite 100, Navy Yard Corporate Center, Philadelphia, PA 19112
Phone: 2159529900

SUSAN ELIZABETH FREDERICKS (NPI# 1023136942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1023136942
Entity Type Individual
Full Name SUSAN ELIZABETH FREDERICKS
Credential PA-C, MPAS
Practice Address 1 Crescent Drive Suite 100
Navy Yard Corporate Center
Philadelphia
PA 19112
Mailing Address 3409 Bleigh Ave
Philadelphia
PA 19136-3818
Practice Telephone 2159529900
Practice Fax Number 2159529977
Mailing Telephone 2153316490
Mailing Fax Number 2159529977
Enumeration Date 2007-03-27
Last Update Date 2009-03-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
MA050951 PA Physician Assistants & Advanced Practice Nursing Providers

Other Providers SUSAN FREDERICKS

NPI Name Taxonomy Address Enumeration
1679805782 Susan Fredericks Dentist 6325 Topanga Canyon Blvd Ste 402, Woodland Hills, CA 91367-2036 2010-02-01

Office Location

Street Address 1 CRESCENT DRIVE SUITE 100
NAVY YARD CORPORATE CENTER
City PHILADELPHIA
State PA
Zip Code 19112

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1265950802 M&m Surgical Center PC Clinic/Center 1 Crescent Dr. Suite 300, Philadelphia, PA 19112 2017-09-05
1710114293 Riverview Surgery Center At The Navy Yard Lp Clinic/Center Three Crescent Drive, Navy Yard Corporate Center, Philadelphia, PA 19112 2009-06-11
1023132867 Healthmark, Incorporated Clinic/Center 1 Crescent Dr., Navy Yard Suite 100, Philadelphia, PA 19112 2007-03-19
1932526258 Anne Catherine Kane Otolaryngology 3 Crescent Dr, Philadelphia, PA 19112 2014-03-25
1255539896 Sheldon Gottlieb Physical Medicine & Rehabilitation 1 Crescent Dr, Suite 100, Philadelphia, PA 19112 2007-07-05
1407074750 Jennifer L Johansen Pharmacist 5 Crescent Dr, Ny0200, Philadelphia, PA 19112-1001 2007-04-23
1679981708 Andrew Trofa Internal Medicine 5 Crescent Dr, Ny 0300, Philadelphia, PA 19112-1001 2014-08-01
1508029463 Robert Williams Carr Preventive Medicine 5 Crescent Dr, Ny 0300, Philadelphia, PA 19112-1001 2008-07-09
1952947152 Navy Yard Dental Associates, Pllc Dentist 1 Crescent Dr Ste 300, Philadelphia, PA 19112-1015 2019-11-22
1174502157 Francis S Matarazzo Dentist 1 Crescent Dr, Suite 300, Philadelphia, PA 19112-1015 2006-01-10
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467051763 Molly Catherine Peters Physician Assistant 4338 Boone St, Philadelphia, PA 19128-4901 2020-10-19
1356951024 Murielle M Boursiquot Physician Assistant 7901 Henry Ave Apt G302, Philadelphia, PA 19128-3072 2020-08-06
1134757156 Julie Hutchison Physician Assistant 2922 N 5th St, Philadelphia, PA 19133-2801 2020-03-27
1174155857 Rebecca Volpe Physician Assistant 738 Longshore Ave, Philadelphia, PA 19111-4325 2020-02-10
1306308879 Ria Raju Physician Assistant 7909 Lawndale Ave, Philadelphia, PA 19111-2652 2019-04-03
1386101400 Ashley Thomas Physician Assistant 9331 Old Bustleton Ave Ste 100a, Philadelphia, PA 19115 2019-02-25
1487119186 Shelby Elizabeth Ginsburg Physician Assistant 1200 W Tabor Rd Fl Bl4, Philadelphia, PA 19141-3019 2019-02-06
1346720059 Noelle Elizabeth Mullanaphy Physician Assistant 4031 Sheffield St, Philadelphia, PA 19136-3101 2018-08-21
1750860490 Anastasiya Khlypnych Physician Assistant 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 2018-08-13
1912409533 Lauren Joy Barton Physician Assistant 5401 N Broad St Ste 363, Philadelphia, PA 19141 2018-02-28
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Competitor

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City PHILADELPHIA
Zip Code 19112

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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