Provider Demographics
NPI:1255310231
Name:MUSIAL, FREDA (NP)
Entity Type:Individual
Prefix:
First Name:FREDA
Middle Name:
Last Name:MUSIAL
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:38935 ANN ARBOR RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3354
Mailing Address - Country:US
Mailing Address - Phone:734-632-0175
Mailing Address - Fax:734-632-0182
Practice Address - Street 1:601 PARK ST
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1445
Practice Address - Country:US
Practice Address - Phone:570-253-8140
Practice Address - Fax:866-250-6385
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2016-06-01
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Provider Licenses
StateLicense IDTaxonomies
MI4704150548363L00000X
VA0024167850363L00000X
PASP009678363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11712562OtherCAQH