Individual
MERIELLE STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
125 LATTIMORE RD STE 150, ROCHESTER, NY 14620-4156
(585) 275-2691
Mailing address
601 ELMWOOD AVE # 668, ROCHESTER, NY 14642-0001
(585) 276-5368
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
235249
MA
207V00000X
Obstetrics & Gynecology Physician
Primary
315654
NY
363AM0700X
Medical Physician Assistant
315654
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2160471
—
MA
Enumeration date
01/04/2007
Last updated
07/17/2023
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