Provider Demographics
NPI:1760758908
Name:FRONCZEK, DAWN ELIZABETH (RD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:ELIZABETH
Last Name:FRONCZEK
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 WISH CIR
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-9655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:574 MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-1751
Practice Address - Country:US
Practice Address - Phone:716-608-3110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-31
Last Update Date:2012-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered