Individual
MRS. ELIZABETH MARIE MIKUSZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
196 NORTH ST, GENEVA, NY 14456-1651
(315) 787-4000
Mailing address
376 PEARL ST, REAR APT, ROCHESTER, NY 14607-3732
(716) 969-4087
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011948
NY
Other
Enumeration date
06/28/2007
Last updated
10/01/2009
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