Search › Pennsylvania › 363A00000X
Jake Defonzo, PA-C
NPI 1013502459 · on the registry since 2021
Practice
- Address
- 100 E Lancaster Ave
Penn Wynne, PA 19096 - Phone
- (484) 476-2000
- Clinicians at this address
- 10
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363A00000X
- Licence states on file
- NY, PA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-09-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Pennsylvania