Individual
KATELYN ANNE TIVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3648 DEWEY AVE, ROCHESTER, NY 14616-3024
(585) 736-3503
Mailing address
3648 DEWEY AVE, ROCHESTER, NY 14616-3024
(585) 736-3503
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
PA6241
MA
Other
Enumeration date
08/28/2017
Last updated
10/30/2023
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