SUSAN ELIZABETH FREDERICKS PA-C MPAS NPI 1023136942

NPI Information

NPI: 1023136942
Provider Name: SUSAN ELIZABETH FREDERICKS, PA-C, MPAS
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
1 CRESCENT DRIVE SUITE 100
NAVY YARD CORPORATE CENTER
PHILADELPHIA, PA
ZIP 19112
Phone: (215) 952-9900
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Susan Elizabeth Fredericks, PA-C, MPAS is a medical physician assistant in Philadelphia, PA. Susan Elizabeth Fredericks, PA-C, MPAS NPI is 1023136942. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1 CRESCENT DRIVE SUITE 100
NAVY YARD CORPORATE CENTER
PHILADELPHIA, PA
ZIP 19112
Phone: (215) 952-9900
Fax: (215) 952-9977

The enumeration date for this NPI number is 3/27/2007 and was last updated on 3/16/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	MA050951	PENNSYLVANIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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