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Individual

MR. COLIN MICHAEL ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
782 E BROADWAY ST, CAPE VINCENT, NY 13618-2204
(315) 654-2530
(315) 654-2832
Mailing address
782 E BROADWAY ST, CAPE VINCENT, NY 13618-2204
(315) 654-2530

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
026718
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06822820
NY
Enumeration date
09/21/2021
Last updated
04/18/2024
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