Individual
MRS. LYDIE-DANIELLE FREDERIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
750 BRUNSWICK AVE, TRENTON, NJ 08638-4143
(609) 394-6000
Mailing address
130 SPEEDWELL AVE, MORRIS PLAINS, NJ 07950-2315
(862) 242-8053
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110010195
VA
363A00000X
Physician Assistant
016255
NY
363A00000X
Physician Assistant
25MP00345300
NJ
Other
Enumeration date
11/20/2012
Last updated
01/06/2025
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