Individual
MRS. LYNN M WENGENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
30 HAGEN DR, SUITE #310, ROCHESTER, NY 14625-2658
(585) 641-0400
(585) 641-0300
Mailing address
30 HAGEN DR, SUITE #310, ROCHESTER, NY 14625-2658
(585) 641-0400
(585) 641-0300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004325
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108994BJ
PREFERRED CARE
NY
01
—
P019004325
BLUE CHOICE PROVIDER NO.
NY
Enumeration date
03/27/2006
Last updated
05/06/2021
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