Individual
CAROLYN ROSE FON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3101 SHIPPERS RD STE 203, VESTAL, NY 13850-2082
(607) 786-4822
Mailing address
20 MILDRED AVE APT 2, JOHNSON CITY, NY 13790-2979
(914) 584-3643
(607) 251-2010
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
032664
NY
363A00000X
Physician Assistant
MA065946
PA
Other
Enumeration date
09/16/2024
Last updated
12/02/2024
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