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Individual

MICHELLE A ROACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
601 ELMWOOD AVE, BOX 635, ROCHESTER, NY 14642-0001
(585) 275-7787
Mailing address
601 ELMWOOD AVE, BOX 635, ROCHESTER, NY 14642-0001
(585) 275-7787

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381153
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02421034
NY
Enumeration date
07/11/2006
Last updated
05/16/2008
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