| Doctor Name: | MR. PETER FREDERICK |
| NPI Number: | 1548411960 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RDO |
| License Number: | 782 |
| Business Practice Address: | 144 Newburyport Tpke Ste A3 Rowley, MA - 019692132 |
| Business Phone Number: | 9789487756 |
| Business Fax Number: | |
| Mailing Address: | 144 Newburyport Tpke Ste A3, ROWLEY |
| State: | MA |
| Postal Code: | 019692132 |
| Phone Number: | 9789487756 |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2008 |
| NPI Last Update Date: | 07/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 782 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NH |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |