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1023145117
EDWARD J FREDERICK
BRONX, NY
NPI
1023145117
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 002473)
Enumeration Date
2007-02-27
Last Update Date
2007-07-08
Business Address
EDWARD J FREDERICK PA
111 E 210TH ST MMC - DEPT. OF MEDICINE
BRONX, NY 10467-2401
Phone number: 718-920-6700
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Mailing Address
EDWARD J FREDERICK PA
110 DEHAVEN DR APT. 222
YONKERS, NY 10703-1278
Phone number: 718-920-6700
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