Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 25MA10296300 | NJ |
NPI | 1487098588 |
---|---|
Provider Name | Rebecca Friess |
First Address | Montclair, NJ 07042 |
Second Address | Berkeley Heights, NJ 07922-2104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2013 |
Last Update Date | 14/07/2021 |