Provider Demographics
NPI:1841330602
Name:FRIEDRICHS, SUSAN X (OT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:X
Last Name:FRIEDRICHS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 WAYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:NJ
Mailing Address - Zip Code:07421-2305
Mailing Address - Country:US
Mailing Address - Phone:973-853-9038
Mailing Address - Fax:973-728-0928
Practice Address - Street 1:2024 MACOPIN RD
Practice Address - Street 2:SUITE E
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1900
Practice Address - Country:US
Practice Address - Phone:973-728-5588
Practice Address - Fax:973-728-0928
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00308000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ097147QXCMedicare ID - Type UnspecifiedOT