Individual
MR. FREDRIC E NOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
107 BERLIN RD, CHERRY HILL, NJ 08034-3526
(856) 429-1800
(856) 429-1081
Mailing address
107 BERLIN RD, CHERRY HILL, NJ 08034-3526
(856) 429-1800
(856) 429-1081
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00314800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
365793
—
NJ
Enumeration date
07/29/2013
Last updated
11/21/2013
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