Provider Demographics
NPI:1740790872
Name:DE FRONZO, CAMERON DANIEL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:DANIEL
Last Name:DE FRONZO
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:241 NEW PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-1736
Mailing Address - Country:US
Mailing Address - Phone:908-578-1492
Mailing Address - Fax:973-912-4367
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-2000
Practice Address - Fax:718-445-0858
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-03
Last Update Date:2022-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY021321363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty