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Individual

AMY MCLEAN-EWANOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1425 PORTLAND AVE, BOX 113, ROCHESTER, NY 14621-3001
(585) 922-4840
Mailing address
1425 PORTLAND AVE, BOX 113, ROCHESTER, NY 14621-3001
(585) 922-4840

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MA052360
PA
363AS0400X
Surgical Physician Assistant
Primary
012334
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02992881
NY
Enumeration date
07/06/2006
Last updated
12/12/2022
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