Individual
DEANNA HELENE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
350 PARRISH ST, CANANDAIGUA, NY 14424-1731
(585) 396-6600
Mailing address
104 HYLAND DR, NORTH SYRACUSE, NY 13212-3811
(315) 559-0875
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
022830
NY
363A00000X
Physician Assistant
22830
NY
Other
Enumeration date
10/15/2018
Last updated
06/30/2023
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