Individual
CARRI L ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4104 VESTAL RD, VESTAL EXECUTIVE PARK SUITE 203, VESTAL, NY 13850-3500
(607) 797-9036
(607) 798-0601
Mailing address
4104 VESTAL RD., VESTAL EXECUTIVE PARK SUITE 203, VESTAL, NY 13850
(607) 797-9036
(607) 798-0601
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
009577-1
NY
363AM0700X
Medical Physician Assistant
0095771
NY
Other
Enumeration date
11/07/2005
Last updated
04/28/2014
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