Provider Demographics
NPI:1225286842
Name:FRIEDBERG, MICHELLE ANN (NP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ANN
Last Name:FRIEDBERG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 2ND AVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-2820
Mailing Address - Country:US
Mailing Address - Phone:781-444-9555
Mailing Address - Fax:
Practice Address - Street 1:75 2ND AVE
Practice Address - Street 2:SUITE 450
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2820
Practice Address - Country:US
Practice Address - Phone:781-444-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA239791363LA2200X
MARN239791363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology