Individual
MR. GERALD SCOTT KINGSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPAC
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0001
(585) 275-5321
Mailing address
601 ELMWOOD AVE BOX 665, ROCHESTER, NY 14642-0001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5800
NY
363AM0700X
Medical Physician Assistant
Primary
005800
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108925CU
PRECARE
—
01
—
5289364
AETNA
—
01
—
P019005800
BCBS
—
Enumeration date
08/01/2006
Last updated
06/20/2025
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