Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edward J Frederick, PA

Individual provider Physician Assistant · NPI 1023145117

Edward J Frederick, PA is a Physician Assistant in Bronx, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

111 E 210th St Mmc - Dept OF Medicine
Bronx, NY 10467-2401
Phone: (718) 920-6700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 002473 (NY)

Record details

NPI number1023145117
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 27, 2007
Last updated in NPPESJuly 8, 2007
Mailing address110 Dehaven Dr, Apt. 222, Yonkers, NY 10703-1278

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