Provider Demographics
NPI:1902809767
Name:FRIEDMAN-LEE, AMY (NP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:FRIEDMAN-LEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UMASS LOWELL
Mailing Address - Street 2:71 WILDER STREET SUITE 5
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854
Mailing Address - Country:US
Mailing Address - Phone:978-276-3143
Mailing Address - Fax:
Practice Address - Street 1:96 NORTH ST
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-1440
Practice Address - Country:US
Practice Address - Phone:978-276-3143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA181504363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP1045OtherBC/BS OF MA
MANP1045OtherBC/BS OF MA
MANP104502Medicare PIN
MANP1045Medicare ID - Type Unspecified
MANP104501Medicare PIN