Individual
SUZANNE WAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1425 PORTLAND AVE, MOB 305, ROCHESTER, NY 14621-3001
(585) 922-9080
Mailing address
1425 PORTLAND AVE, MOB 305, ROCHESTER, NY 14621-3001
(585) 922-9080
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007527
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02407096
—
NY
Enumeration date
07/12/2006
Last updated
05/06/2021
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