Provider Demographics
NPI:1235253402
Name:FRENDLING, ANDREA M (PA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:FRENDLING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:LAHEY CLINIC PROVIDER ENROLLMENT
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:781-744-8923
Mailing Address - Fax:781-744-5215
Practice Address - Street 1:41 MALL RD
Practice Address - Street 2:LAHEY CLINIC DEPARTMENT OF PULMONARY AND CRITICAL CARE
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01805-0001
Practice Address - Country:US
Practice Address - Phone:781-744-1823
Practice Address - Fax:781-744-3443
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2296363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAP285701Medicare PIN