Provider Demographics
NPI:1518927680
Name:FROHNHOEFER, CARYN ANN (PA)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:ANN
Last Name:FROHNHOEFER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:ANN
Other - Last Name:LOVLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:79 MIDDLEVILLE RD
Mailing Address - Street 2:NORTHPORT VA MEDICAL CENTER
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2200
Mailing Address - Country:US
Mailing Address - Phone:631-261-4400
Mailing Address - Fax:631-266-6051
Practice Address - Street 1:79 MIDDLEVILLE RD
Practice Address - Street 2:NORTHPORT VA MEDICAL CENTER
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2200
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:631-266-6051
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07555363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical