MEDICARE: AMY FRIEDMAN-LEE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	181504	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NP1045	OTHER	MA	BC/BS OF MA

General Provider Information

NPI Number	:	1902809767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY FRIEDMAN-LEE NP

Provider Business Mailing Address
First Line	:	UMASS LOWELL
Second Line	:	71 WILDER STREET SUITE 5
City	:	LOWELL
State	:	MA
Zip	:	01854
Country	:	US
Telephone Number	:	978-276-3143
Fax Number	:

Provider Business Practice Location Address
First Line	:	96 NORTH ST
Second Line	:
City	:	NORTH READING
State	:	MA
Zip	:	01864-1440
Country	:	US
Telephone Number	:	978-276-3143
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	02/11/2009

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