Individual provider · Type 1 NPI

Tianna I. Fredericks, MD

Student in an Organized Health Care Education/Training Program · West Orange, NJ

NPI number 1922800135 Active

Practice location

9 Cornell St
West Orange, NJ 07052-2509

Call (973) 900-3597 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1922800135

Tianna I. Fredericks, MD's National Provider Identifier is 1922800135, issued on Mar 26, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in West Orange, NJ. The record was last updated on Mar 26, 2025.