Provider Demographics
NPI:1194905133
Name:FRIEDRICH, LISA M (APN-C)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:M
Last Name:FRIEDRICH
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2052 MORRIS AVE
Mailing Address - Street 2:SUITE # 300
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6028
Mailing Address - Country:US
Mailing Address - Phone:908-994-8880
Mailing Address - Fax:908-994-8882
Practice Address - Street 1:500 BAYBERRY LN
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-1401
Practice Address - Country:US
Practice Address - Phone:908-789-0471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO09672100163W00000X
NJ26NJ0016990363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse