MR. FREDRIC E NOLLER (NPI# 1790127934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790127934 |
| Entity Type | Individual |
| Full Name | MR. FREDRIC E NOLLER |
| Credential | PA-C |
| Practice Address |
107 Berlin Rd Cherry Hill NJ 08034-3526 |
| Practice Telephone | 8564291800 |
| Practice Fax Number | 8564291081 |
| Mailing Telephone | 8564291800 |
| Mailing Fax Number | 8564291081 |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 25MP00314800 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 365793 | 05 |
| Street Address |
107 BERLIN RD |
| City | CHERRY HILL |
| State | NJ |
| Zip Code | 08034-3526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780682278 | Ira David Horowitz | Internal Medicine | 107 Berlin Rd, Cherry Hill, NJ 08034-3526 | 2005-07-08 |
| 1376003137 | Jacquelyn Christine Ross | Nurse Practitioner | 107 Berlin Rd, Cherry Hill, NJ 08034-3526 | 2019-03-20 |
| 1003214842 | Brian Hugh Shannon | Nurse Practitioner | 107 Berlin Rd, Cherry Hill, NJ 08034-3526 | 2014-12-10 |
| 1770920720 | David Baumgarten | Internal Medicine | 107 Berlin Rd, Cherry Hill, NJ 08034-3526 | 2013-05-31 |
| 1184918351 | Julie Ninja Polisiakiewicz | Internal Medicine | 107 Berlin Rd, Cherry Hill, NJ 08034-3526 | 2011-06-06 |
| 1285875633 | Aaron David Crookshank | Internal Medicine | 107 Berlin Rd, Cherry Hill, NJ 08034-3526 | 2009-03-16 |
| 1497946792 | Michael Joseph Driscoll V | Internal Medicine | 107 Berlin Rd, Cherry Hill, NJ 08034-3526 | 2007-08-05 |
| 1053519702 | Antonio Quiachon Velasco Jr. | Internal Medicine | 107 Berlin Rd, Cherry Hill, NJ 08034-3526 | 2007-07-04 |
| 1093734022 | Pulmonary and Sleep Associates of South Jersey, LLC | Internal Medicine | 107 Berlin Rd, Cherry Hill, NJ 08034-3526 | 2006-07-19 |
| 1629018825 | Srirekha Dayanidhi | Physician Assistant | 107 Berlin Rd, Cherry Hill, NJ 08034-3526 | 2006-06-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821606054 | Glickman Psychological Services, LLC | Psychologist | 80 Barclay Center, Suite 4, Cherry Hill, NJ 08034 | 2020-07-14 |
| 1215455225 | Arc of Camden County Millhurst Supported Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 141 Hayes Mill Road, Apt 218, Cherry Hill, NJ 08034 | 2017-08-30 |
| 1144748120 | Arc of Camden County Chanticleer Drive Supported Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 712 Chanticleer Drive, Cherry Hill, NJ 08034 | 2017-08-30 |
| 1124558689 | 1 Choice Home Health Care, LLC | Home Health | 1409 E. Highway 70, Barclay Pavilion, Suite 207w, Cherry Hill, NJ 08034 | 2017-06-18 |
| 1205362621 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 405 Wayland Rd, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1598291940 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19 Brookdale Dr, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1861928285 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 302 Portsmouth Rd, Cherry Hill, NJ 08034 | 2017-05-04 |
| 1265967954 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8 Farmhouse Ln, Maple Shade, NJ 08034 | 2017-05-01 |
| 1023543709 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 407 Cranford Rd, Cherry Hill, NJ 08034 | 2017-05-01 |
| 1588199269 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21 Colgate Drive, Cherry Hill, NJ 08034 | 2017-05-01 |
| Find all providers in zip 08034 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629603873 | Alana Seidman | Physician Assistant | 13 Lucerne Ct, Cherry Hill, NJ 08003-5119 | 2020-03-09 |
| 1629445184 | Lisa Robin Rubinstein | Physician Assistant | 307 Juniper Dr, Cherry Hill, NJ 08003-3125 | 2015-08-31 |
| 1639588924 | Julie Rubin | Physician Assistant | 122 Weather Vane Dr., Cherry Hill, NJ 08002 | 2014-08-12 |
| 1780098749 | Kristen Carr | Physician Assistant | 310 Elma Ave, Cherry Hill, NJ 08002-1417 | 2014-06-18 |
| 1679607352 | Lynn M Morgenstern | Physician Assistant | 1904 Lark Ln, Cherry Hill, NJ 08003-2919 | 2007-03-15 |
| 1902314891 | Etya Schecter | Physician Assistant | 1400 Route 70 E, Cherry Hill, NJ 08034-2240 | 2018-01-13 |
| 1336519297 | Richard H. Bengel | Physician Assistant | 1 Brace Rd Ste H, Cherry Hill, NJ 08034-2600 | 2015-10-04 |
| 1700142064 | Emily Joy Bear | Physician Assistant | 800 Haddonfield Rd, Cherry Hill, NJ 08002-2604 | 2012-04-11 |
| 1285935981 | Nadine G. Miles | Physician Assistant | 1907 Greentree Rd, Cherry Hill, NJ 08003 | 2010-11-11 |
| 1417257858 | Maria Elena Long | Physician Assistant | 800 Haddonfield Rd, Cherry Hill, NJ 08002-2604 | 2010-11-02 |
| Find all providers in CHERRY HILL | ||||
| City | CHERRY HILL |
| Zip Code | 08034 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.