Provider Demographics
NPI:1568277689
Name:DEL ROSARIO, LIEZL CATHERINE C (PA-C)
Entity type:Individual
Prefix:
First Name:LIEZL CATHERINE
Middle Name:C
Last Name:DEL ROSARIO
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9425 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5069
Mailing Address - Country:US
Mailing Address - Phone:718-760-0797
Mailing Address - Fax:718-760-0797
Practice Address - Street 1:11706 225TH ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-1706
Practice Address - Country:US
Practice Address - Phone:718-712-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant