Individual
KATHRYN MAUREEN GODSHALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1561 LONG POND RD, SUITE 303, ROCHESTER, NY 14626-4117
(585) 368-6500
(585) 368-6501
Mailing address
1561 LONG POND RD, SUITE 303, ROCHESTER, NY 14626-4117
(585) 368-6500
(585) 368-6501
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
018817
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04247536
—
NY
Enumeration date
07/22/2015
Last updated
12/18/2015
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