Individual
JILLIAN ELIZABETH DIGIOVANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1415 PORTLAND AVE, ROCHESTER, NY 14621-3038
(585) 922-4200
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-0553
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
023305
NY
363AM0700X
Medical Physician Assistant
Primary
023305
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14413853
CAQH
NY
Enumeration date
02/20/2019
Last updated
04/20/2023
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